Mitral valve prolapse: two dimensional echocardiography reveals a high prevalence in three to twelve year old children.

The prevalence of mitral valve prolapse (MVP) appears to be age related, MVP being commoner in children as compared to adults. This suggests that asymptomatic MVP may be most frequent in children who are very young. In this study, to better define the prevalence of MVP in young children, we used two dimensional echocardiography and prospectively surveyed 213 healthy urban school children between 3 and 12 years of age. MVP was diagnosed when prolapse of mitral leaflet/s was demonstrated by both two-dimensional and M-mode echocardiography at parasternal long-axis views. Overall, MVP was found in 28 of 213 (13.1%) children. MVP was similarly prevalent in all age groups studied (3-5.9 years: 13 of 83 (13.5%); 6-8.9 years: 9 of 71 (11.2%); and 9-12 years: 6 of 31 (16.2%) children; Chi square = 0.57, p greater than 0.5). Univariate analysis showed that the prevalence of MVP was independent of sex, birth weight, resting heart rate and systolic or diastolic blood pressure. A mid systolic murmur was present in 50.6% of the children although it correlated with echocardiographic diagnosis of MVP in only 39.3%. The left ventricular size or wall thickness and mitral EF and DE slopes were similar in children either with or without MVP. Our results indicate that asymptomatic MVP is frequent in children upto 12 years of age. As a diagnostic test of MVP, presence of apical systolic murmur is considerably inferior to echocardiography. No morphological left ventricular correlates were identified in MVP.