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 prolapse who want to/or participate in competitive sports, and to decide who of them will take permission 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. As methods were used noninvasive testings:12 channel ECG, 2D Doppler echocardiography, Holter 24 hour monitoring, chest X ray and stress test in selected patients. Results. The majority of teenagers ( 35/45) were boys and 10 were girls. 33/45 were athletes, 12/45 came with the wish to become athletes. At initial presentation, 40 were asymptomatic; 2 /45 had palpitation; 3/45 chest pain. Sinus arrhythmia on ECG had 3/45 pts, 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 pts, 5/45 was found to have severe MVP with severe regurgitation. Three of them was first time on cardiologic check-up (starting sporting without previous permission to practice sport), 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 examinees. 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 examinees with significant PVC were using antiarrhythmic drugs. Stress test was performed in 5/45 pts and it was negative in all of them.7/45 had thoracic deformities (pectus excavatus and scoliosis) shown. Conclusion. Most teenagers with MVP can safely participate in all activities. MVP is usually benign condition. The athletes should have periodical ( 6-12 months) regular check-up in department on pediatric or adult cardiology. Usually, they must perform ECG and echocardiography. The other investigation – Holter 24 hour ECG, Chest X ray and stress test in recommendation for certain athlete. The finding of MVP with mitral regurgitation is very dangerous for an athlete. Those with mild regurgitation may participate in easier sports, unlike those with severe mitral regurgitation who have not permission for sport. The children who want to practice sport should be supported by their parents, after first regular cardiologic consultation before sporting, where the pediatric or adult cardiologist shall decide and give them permission to practice sports

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