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Clinical characteristics of primary mitral valve prolapse syndrome in children
W Rokicki1, J Krzystolik-Ladzińska, B Goc
1Department of Paediatric Cardiology, Silesian Medical School, Katowice, Poland.
Insights
Primary mitral valve prolapse (MVP) in children often presents with cardiac symptoms and can be linked to genetic factors. Physical performance remains normal despite ECG abnormalities in many cases.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Diseases
- Echocardiography
Background:
- Primary mitral valve prolapse (MVP) affects children, necessitating comprehensive evaluation.
- Understanding the clinical presentation and associated conditions in pediatric MVP is crucial.
Purpose of the Study:
- To investigate the clinical characteristics, diagnostic findings, and physical performance in children with primary mitral valve prolapse (MVP).
Main Methods:
- Studied 67 children (ages 5-18) with primary MVP.
- Utilized physical examination, echocardiography, routine ECG, 24-hour Holter monitoring, and Bruce protocol physical performance tests.
- Collected data on symptoms, family history, physical constitution, and ECG/Holter findings.
Main Results:
- Common referral reasons included cardiac murmur (85%), palpitations (40%), and chest pain (31%).
- ECG abnormalities were noted in 67%, with rhythm disturbances in 22% during Holter monitoring.
- Familial inheritance was suggested in over 20%, and asthenic constitution with orthopedic issues in 20%.
Conclusions:
- Pediatric primary mitral valve prolapse (MVP) presents with diverse symptoms and frequent ECG abnormalities.
- Despite cardiac findings, physical performance in these children is generally preserved.
- Associated factors like genetics and physical constitution warrant consideration in pediatric MVP management.
Abstract:
Sixty-seven children (40 girls and 27 boys) suffering from primary mitral valve prolapse (MVP) were studied. The age of these subjects was 5 to 18 years with the mean 12.8 +/- 3.3 years. MVP was diagnosed on the basis of physical and echocardiographic examination. In every case following studies were performed: routine and 24-hours ECG (according to Holter method), echocardiography, and physical performance test (according to Bruce protocol). The cause of referring the child to cardiologist were: cardiac murmur with/or midsystolic click in 85%, chest pain in 31%, feeling of cardiac palpitations in 40%, loss of consciousness in 40%, increased fatigability in 22%, feeling of dyspnoea in 10.5% (there were often more than one symptom in the same subject). Familial inheritance of MVP was suggested in over 20% of our patients. Asthenic constitution with orthopedic disorders (e.g. important scoliosis, pectus excavatum etc.) was found in about 20% of studied children. In 15% so called silent MVP was recognized. In 19% of subjects mitral valve leaflets inspection indicated their thickening and redundancy. In 67% routine ECG showed abnormalities of cardiac rhythm, conduction or repolarization. During Holter monitoring rhythm disturbances were detected in 22% of patients. Physical performance test results were normal in every case.