Clinical characteristics of primary mitral valve prolapse syndrome in children.

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.