Mitral Valve Prolapse in Childhood: The Incidence and Clinical Presentations in Different Age Groups

Abstract

To elucidate the incidence and natural history of mitral valve prolapse (MVP) during childhood, we investigated a total of 4,238 children (aged from 1 day to 15 years) classified by age into 4 groups: Group 1 : 1 to 28-day-old full-term normal newborns (n = 108), Group 2: 6 to 18-month-old infants (n = 391), Group 3: 6 to 7-year-old children (n = 2,801), and Group 4: 12 to 15-year-old children (n = 938). The incidence of MVP was determined by videorecorded two-dimensional echocardiography in a double-blind method twice-over. There were 109 cases diagnosed as having MVP. The incidence rates of MVP were as follows: Group 1: O%, Group 2: 0.25%, Group 3: 2.1% and Group 4: 5.1%. Arrhythmias were detected in 49% (27/55) by Holter ECG, and by exercise stress test in 4.7% (2/43). Eighty-three (77%) of 108 cases in Groups 3 and 4, excluding the 1 case in Group 2, showed no symptoms. Ventricular premature contraction (VPC) was the most common arrhythmia, and was benign in all cases. A mid-systolic click (MSC), late systolic murmur (LSM), MSC -t LSM, and a pansystolic murmur were detected in 23.1%, 3.7%, 4.6% and 5.6%, respectively. Symptoms caused by MVP increased and appeared more apparently with age. Further prospective long-term follow-up studies to adulthood are necessary. population. However, there are few studies reporting the incidence and clinical presentations of MVP in children. The incidence of MVP in adults is still uncertain and published figures vary in a wide range from 1% [2] to nearly 20% [ 11. To elucidate the incidence and natural history of childhood MVP, we have investigated 4,238 healthy infants and children by two-dimensional echocardiography and have studied their clinical presentations, symptoms and incidence of arrhythmias.

Floppy Mitral Valve (FMV)/Mitral Valve Prolapse (MVP) and the FMV/MVP Syndrome: Pathophysiologic Mechanisms and Pathogenesis of Symptoms

“…The term FMV comes from surgical and pathologic studies and refers to the expansion of the area of the mitral valve leaflets with elongated chordae tendineae, chordae tendineae rupture and often mitral annular dilatation [2,5,7]. The prevalence of FMV/MVP as defined above in the general population is 2-3% [2,8,9,10,11,12,13]. It is important to separate studies where the diagnosis was based solely on prolapse of the mitral valve without defining if the mitral valve was ‘floppy' or not.…”

Congenital Anomalies of the Mitral Valve

“…Interestingly, patients with mitral valve prolapse have a high incidence of autonomic dysfunction, leading to symptoms out of proportion to their degree of mitral valve disease. The incidence of mitral valve prolapse in asymptomatic children increases considerably by age 15 . Various studies have found an overall incidence in children 0–18 years of age of 0.3%, 16 and an incidence in adolescents as high as 5% 15 .…”

“…The incidence of mitral valve prolapse in asymptomatic children increases considerably by age 15 . Various studies have found an overall incidence in children 0–18 years of age of 0.3%, 16 and an incidence in adolescents as high as 5% 15 . In a study of patients known to have mitral valve prolapse, the majority were asymptomatic, and 20% had associated skeletal or connective tissue disease 17 .…”

Mitral Valv Prolapsuslu Çocuklarda Tanı Kriterleri ve İzlem

“…Kliniğimizdeki MVP'li hastaların %20'sinde olduğu gibi göğüs ağrısı genellikle atipik ve nonpesifiktir, anjina pektorise benzemez ve egzersiz ile provake olmaz. Nedeni kesin olarak bilinmemekle birlikte papiller kaslar ve ventrikül duvarı üzerindeki artmış basınca ve koroner arterlerdeki spazma bağlı olarak geliştiği dü-şünülmektedir (16).…”