Mitral Valve Prolapse in Children: Symptoms, Treatment, and Management

Mitral valve prolapse

Hello, my son is 11 years old this year, in the fourth grade.
Recently, during a school health check, an abnormal electrocardiogram was found.
He later went to Zhongxiao Hospital for a follow-up and was diagnosed with mitral valve prolapse and some obstruction in one of the heart's pathways that occasionally causes blockages.
The doctor mentioned it might be hereditary.
However, my husband has undergone a health check and has no such issues, and neither my in-laws nor my parents or other family members have experienced symptoms associated with mitral valve prolapse, such as fainting or chest discomfort.
The doctor said that currently, no treatment is needed, and only monitoring is required.
Is this correct? Is this condition serious? How can it be prevented and treated? Is surgery or medication an option? Please advise.
Thanks a lot in advance.

Lai, 10~19 year old female. Ask Date: 2002/04/25

Dr. Chen Guifeng reply Cardiology

Based on the description, it should be classified as mitral valve prolapse syndrome.
The heart primarily has two conduction pathways on the left and right sides, with right bundle branch block being a common occurrence that does not affect cardiac physiological function.
Mitral valve prolapse syndrome is a common issue that does not exhibit hereditary patterns; however, individuals who are more neurotic may experience heightened neurogenic responses, particularly during times of stress, anxiety, emotional agitation, or fatigue.
This can lead to symptoms such as chest tightness, chest pain, shortness of breath, or fainting.
The condition is not severe, and it is important to maintain a normal daily routine, reduce stress, and alleviate tension as preventive measures.
Surgical intervention is not necessary, and pharmacological treatment is only indicated for those with more severe symptoms.

Reply Date: 2002/04/25

More Info

Mitral Valve Prolapse (MVP) is a condition where one or both of the flaps (leaflets) of the mitral valve do not close properly, which can lead to various symptoms and complications. In children, MVP is often asymptomatic and may be discovered incidentally during routine examinations, such as an ECG or echocardiogram.

Symptoms
In many cases, children with MVP do not experience any symptoms. However, some may report palpitations, chest pain, fatigue, or shortness of breath, especially during physical activity. It is important to note that these symptoms can also be associated with other conditions, so a thorough evaluation by a healthcare professional is essential.

Diagnosis
The diagnosis of MVP is typically confirmed through an echocardiogram, which provides a visual assessment of the heart's structure and function. An abnormal ECG may suggest electrical conduction issues, but it does not definitively diagnose MVP. Your child's doctor may have noted that there is a "blockage" or "disruption" in one of the heart's electrical pathways, which can occur alongside MVP but is not directly caused by it.

Treatment and Management
In most cases, MVP in children does not require treatment. If your child is asymptomatic and there are no significant complications, regular follow-up appointments with a pediatric cardiologist are usually sufficient. The doctor may recommend echocardiograms at regular intervals to monitor the condition and ensure that there are no changes in the heart's function or structure.

If your child begins to experience symptoms or if the mitral valve regurgitation (backward flow of blood) becomes significant, treatment options may include:
1. Medications: Beta-blockers may be prescribed to help manage symptoms such as palpitations or anxiety. However, they are not necessary for all children with MVP.

2. Lifestyle Modifications: Encouraging a healthy lifestyle, including regular exercise, a balanced diet, and avoiding stimulants (like caffeine), can be beneficial.

3. Surgery: Surgical intervention is rare in children with MVP unless there are severe complications, such as significant mitral regurgitation leading to heart failure or arrhythmias. In such cases, surgical options may include mitral valve repair or replacement.

Prognosis
The prognosis for children with MVP is generally very good. Most children lead normal, active lives without any significant limitations. Regular follow-up with a healthcare provider is key to monitoring the condition and addressing any emerging issues.

Family History
While MVP can have a genetic component, it is not uncommon for it to appear in families without a known history of the condition. It is possible for MVP to occur sporadically, even if immediate family members do not exhibit symptoms or have not been diagnosed.

Conclusion
In summary, it sounds like your child's condition is being appropriately managed with regular follow-up and monitoring. If there are no symptoms or significant findings on echocardiograms, the recommendation to simply observe is standard practice. However, if you have concerns or if your child begins to experience symptoms, do not hesitate to reach out to your healthcare provider for further evaluation. Keeping an open line of communication with your child's doctor will ensure that any changes in health are promptly addressed.

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