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

Health providers performed a detailed physical examination including echocardiography on 213 3-12 year old children attending an urban middle-class school in Jaipur India to determine the prevalence of mitral valve prolapse (late systolic prolapse and holo systolic prolapse). They divided the children into 3 groups: 3-5.9 year olds 6-8.9 year olds and 9-12 year olds. None of the children had vitamin deficiencies or protein calorie malnutrition. Mitral valve prolapse stood at 13.1% (28 children) for all 3 groups combined. The prevalence was similar for all groups (13.5% for 3-5.9 year olds 11.2% for 6-8.9 year olds and 16.2% for 9-12 year olds). Further mitral valve prolapse prevalence was not significantly different between girls and boys (13.9% vs. 12.6%). By listening to the heart health providers detected a systolic murmur in 39.3% (11) of the children with echocardiographic-confirmed mitral valve prolapse compared to just 11.3% (21) of the children without echocardiographic proof of mitral valve prolapse (p < .001). Thus systolic murmur was not sensitive in diagnosing mitral valve prolapse but was more specific in identifying those children without mitral valve prolapse. Echocardiographic measurements of left ventricular diastolic dimension posterior wall and septal thickness of children with mitral valve prolapse were not significantly different than those without mitral valve prolapse. The same was true for mitral value EF and DE slopes. 2 children with mitral valve prolapse exhibited mild thickening of the posterior cusp. 1 child showed a secundum atrial septal defect. Another child had a small ventricular septal defect. Longterm prospective studies of young children with mitral valve prolapse are needed to describe the natural history and clinical relevance of this condition.