Abstract
Background
Mitral valve prolapse (MVP) is the most common primary valvular abnormality in a young population. In some individuals, MVP is silent or associated with palpitations, dizziness, chest pain, and abnormal electrocardiogram (ECG) repolarization with or without ventricular arrhythmias.
Hypothesis
The aim of the present study was to assess the occurrence of the clinical and electrocardiographic abnormalities in young athletes with silent MVP.
Methods
A group of 10 children, who have been sport training intensively, with preparticipation silent MVP were examined for symptoms and/or ECG abnormalities. The diagnosis of MVP was made by echocardiography.
Results
Three athletes were asymptomatic at initial presentation. The other 7 athletes presented with symptoms. The QTc intervals > 440 msec were recorded in 2 athletes (1 with syncope). Abnormal ECG repolarization was found in 7 athletes (4 athletes were symptomatic and 3 were asymptomatic). A large variety of T‐waves was registered in athletes who presented with symptoms. In asymptomatic athletes, the tall and flat T‐waves were recorded.
Conclusions
Young athletes with MVP are often predisposed to electrocardiographic abnormalities of ventricular repolarization, which requires annual cardiologic evaluation. Copyright © 2009 Wiley Periodicals, Inc.
Full Text
The Full Text of this article is available as a PDF (91.0 KB).
References
- 1. Freed LA, Levy D, Levine RA, et al. Prevalence and clinical outcome of mitral valve prolapse. N Eng J Med 1999; 341: 1–7. [DOI] [PubMed] [Google Scholar]
- 2. Savage DD, Garrisson RJ, Devereux RB, et al. Mitral valve prolapse in the general population. 1‐Epidemiologic features: The Framingham Study. Am Heart J. 1983. 106: 571–576. [DOI] [PubMed] [Google Scholar]
- 3. Corrado D, Basso C, Buja G, et al. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol 2003; 42: 1959–1963. [DOI] [PubMed] [Google Scholar]
- 4. Cheitlin MD, Alpert JS, Armstrong WF, et al. ACC/AHA guidelines for the clinical application of echocardiography. Circulation 1997; 95: 1686–1744. [DOI] [PubMed] [Google Scholar]
- 5. Markiewicz‐Łoskot G, Michalewska A, WŁudarczyk W, Rokicki W. Comparison of clinical presentation and evaluation of repolarization period in children with idiopathic mitral valve prolapse and in Marfan syndrome. Postȩpy Neonatologii (suppl 1) 2000; 128–132. [Google Scholar]
- 6. Rokicki W, Szewieczek J, Markiewicz‐Łoskot G, Foit E, Michalak K. Heart valve function in children intensively training sport. Medicina Sportiva 2001; 5: 53–58. [Google Scholar]
- 7. Markiewicz‐Łoskot G, Łoskot M, Szyd3owski L. Basal cardiovascular adaptations and cardiac arrhythmias in children intensively training sport. Medicina Sportiva Practica 2005; 6: 47–51. [Google Scholar]
- 8. Markiewicz‐Łoskot G, Łoskot M, Szyd3owski L. Clinical signi‐ ficance of ECG repolarization parameters in children intensively training sport. Medicina Sportiva Practica 2005; 6: 53–56. [Google Scholar]
- 9. Kligfield P, Levy D, Devereux RB, Savage DD. Arrhythmias and sudden death in mitral valve prolapse. Am Heart J 1987;113: 1298–1307. [DOI] [PubMed] [Google Scholar]
- 10. Kulan H, Komsuoglu B, Tuncer C, Kulan C. Significance of QT dispersion on ventricular arrhythmias in mitral valve prolapse. Int J Cardiol 1996; 54: 251–257. [DOI] [PubMed] [Google Scholar]
- 11. Schwartz PJ, Moss AJ, Vincent GM, Crampton RS. Diagnostic criteria for the long QT syndrome: An update. Circulation 1993; 88: 782–784. [DOI] [PubMed] [Google Scholar]
- 12. Garson A. The electrocardiogram in infants and children: A systematic approach. Philidelphia: Lea & Febiger 1983; 396–404. [Google Scholar]
- 13. Cumming GR, Everatt D, Hastman L. Bruce treadmill test in children: Normal values in a clinic population. Am J Cardiol 1978; 41: 69–75. [DOI] [PubMed] [Google Scholar]
- 14. Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: An executive summary. A report of the American College of Cardiology/ American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines. Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Eur Heart J 2006; 27: 2099–2140. [DOI] [PubMed] [Google Scholar]
- 15. Fauchier L, Maison‐Blanche P, Forhan A, et al. Association between heart rate‐corrected QT interval and coronary risk factors in 2894 healthy subjects. Am J Cardiol 2000; 86: 557–559. [DOI] [PubMed] [Google Scholar]
- 16.No authors listed. 26th Bethesda Conference: Recommendations for determining eligibility for competition in athletes with cardiovascular abnormalities. J Am Coll Cardiol 1994; 24: 845–899. Erratum in: Med Sci Sports Exerc 1994;26:1421–1425.7798484 [Google Scholar]
- 17. Pelliccia A, Fagard R, Bjornstad HH, et al. Recommendations for competitive sports participation in athletes with cardiovascular disease. A consensus document from the Study Group of Sports Cardiology of the Working Group Cardiac Rehabilitation and Exercise Psychology and the Working Group of Myocardial and Pericardial Disease of the European Society of Cardiology. Eur Heart J 2005; 26: 1422–1445. [DOI] [PubMed] [Google Scholar]
- 18. Corrado D, Pelliccia A, Bjornstad HH, et al. Cardiovascular pre‐participation screening of young competitive athletes for prevention of sudden death: Proposal for a common European protocol. Consensus Statement of the Study Group of Sports Cardiology of the Working Group Cardiac Rehabilitation and Exercise Psychology and the Working Group of Myocardial and Pericardial Disease of the European Society of Cardiology. Eur Heart J 2005; 26: 516–524. [DOI] [PubMed] [Google Scholar]
