MITRAL VALVE PROLAPSE IN TEENAGERS AND COMPETITIVE SPORTS

Kuzevska-Maneva K., Kacarska R., Gjurkova-Angelovska B., Maneva E., Jovanovska V., Neshkovska- Shumenkovska M., Georgieva D., Georgiev A.

The aim of the present study was to evaluate the teenagers with mitral valve prolaps who want/or participate in competitive sports, and to decide which of them will have approval for professional sporting in their future life. Material and methods. Forty five teenagers aged 13-18 y (mean 13,2 +/- 2,4 y) with mitral valve prolapse were analyzed. The testing methods used were noninvasive: 12 channel ECG, 2D Doppler echocardiography, 24 hour monitoring Holter, chest X ray and stress test in selected patients. Results. The majority of teenagers (35/45) were boys and 10 of them were girls. 33/45 were sportsmen, 12/45 came with the wish to become a sportsman. At initial presentation 40 were asymptomatic; 2 /45 had palpitation; 3/45 chest pain. Sinus arrhythmia on ECG had 3/45 patients, premature atrial contraction (PAC) 2/45, premature ventricular contraction (PVC) had 7/45 children. Abnormal ECG repolarization was found in 4/45 teenagers. On echocardiography despite the findings of mild MVP (88,88%) in most patients, 5/45 was found to have severe MVP with severe regurgitation. Three of them was first time on cardiologic check-up (starting sporting before without approval to do sports activity), 2/5 had developed severe MV regurgitation several year after diagnosis of mild MVR. Normal Holter 24 hour electrocardiogram was found in 25 (55%) of the patients. In 20 (45.45%) we found different type of heart rhythm disturbances (PVC 13/45; PVC 5/45; transient nodal rhythm 3/45;AV block first degree 1/45; AV block second degree-Wenckebach 1/45). Only 2/5 with significant PVC were taking antiarrhythmic drugs. Stress test was performed in 5/45 patients it was negative in all of them. 7/45 had thoracic deformities (pectus exavatus and scoliosis) shown. Conclusion. Most teenagers with MVP can participate in all activities safely. MVP is usually in benign condition. The sportsmen should have periodical (6-12 months) regular check-up in department on pediatric or adult cardiology. Usually, they must undergo ECG and echocardiography. The other investigation – Holter 24 hour ECG, Chest X ray and stress test is recommended for certain sportsmen. The findings of MVP with mitral regurgitation is very dangerous for the sportsmen. Those with mild regurgitation may participate in easier sports, unlike those with severe mitral regurgitation who will not have permission for sport. The children who want to do sports activities should be supported by their parents, once they have the regular cardiologic consultation before sporting, where the pediatric or adult cardiologist shall make appropriate decision and approve practicing sports.

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