Mitral valve prolapse in a runner

In the past decade mitral valve prolapse has become a popular diagnosis. This may be related to the increased utilisation of cardiac ultrasound diagnostic techniques. Although many initial medical articles highlighted patients with complications of mitral valve prolapse, the natural history of isolated mitral systolic click is benign. Complications are sudden cardiac death, symptomatic cardiac arrhythmias, endocarditis, ruptured chordea tendinae, progressive mitral regurgitation, and cerebral ischemic events. However, these occur more likely in patients with MVP and associated mitral regurgitation and/or ECG repolarization abnormalities. The subject in this case example had nonanginal chest pain possibly related to silent mitral valve prolapse, documented on echocardiography. There is a coincidental finding of "athletic heart" on electrocardiogram. Stress ECG and thallium scintography showed excellent cardiorespiratory fitness and normal myocardial perfusion. He was given reassurance that there was no significant cardiac problem, and subsequently completed a marathon run without consequence.