Mitral Valve Prolapse in Sports

The mitral valve is a valve in the heart that prevents blood from going the wrong direction, allowing the heart to work efficiently. Sometimes, the mitral valve fails to do its job, and a small amount of blood leaks through the valve when it is closed. This condition is known as a mitral valve prolapse. A mitral valve prolapse can be heard and diagnosed by a physician with the use of a stethoscope. It is generally thought to be a harmless condition, unless associated with fainting (syncope), a family history of sudden death, or abnormal heart rhythms.

SYMPTOMS

  • Generally, no symptoms.

  • Fainting (syncope).

  • Rapid or irregular heartbeat (palpitations).

  • Fatigue.

  • Anxiety.

  • Stroke (cerebrovascular accident).

  • Chest pain.

  • Increased difficulty breathing (dyspnea).

  • Abnormal heart rhythms (arrhythmias).

  • Sudden death.

CAUSES

Most cases of mitral valve prolapse have no known cause. The condition is associated with diseases of connective tissue, such as Marfan syndrome.

RISK INCREASES WITH:

  • Hypertrophic cardiomyopathy (enlarged heart).

  • Connective tissue diseases, such as Marfan syndrome or Ehlers-Danlos syndrome.

  • Rheumatic fever.

PREVENTION

  • Some individuals with a mitral valve prolapse need to take antibiotics before having dental work or other surgical procedures. This is called prophylactic antibiotic treatment. These drugs help to prevent infective endocarditis. Antibiotics are only recommended for individuals with the highest risk for developing infective endocarditis. Let your dentist and your caregiver know if you have a history of any of the following so that the necessary precautions can be taken:

  • A VSD.

  • A repaired VSD.

  • Endocarditis in the past.

  • An artificial (prosthetic) heart valve.

  • When associated with fainting, athletes are often asked to reduce training.

  • When associated with Marfan syndrome, athletes are screened for progression of the condition.

PROGNOSIS

Mitral valve prolapse often has no negative consequences, and does not need to be treated.

RELATED COMPLICATIONS

Since mitral valve prolapse is considered a harmless condition, the risk of complications is low. However, mitral valve prolapse may be related to the following:

  • Sudden death.

  • Infection of the heart lining (bacterial endocarditis).

  • Abnormal heart rhythms (arrhythmias).

  • Blood clots formed in the heart, which can travel to other organs (emboli).

  • Stroke.

TREATMENT

Most cases of mitral valve prolapse are left untreated. If the leak in the valve begins to cause symptoms, surgery must be performed to replace the valve. You may want to discuss changes in activity levels with your caregiver.

MEDICATION

No medicines exist to treat mitral valve prolapse.

ACTIVITY

No activity restrictions are required, unless symptoms prevent participation.

DIET

No dietary changes are required to treat this condition.

SEEK MEDICAL CARE IF:

  • There is a change in exercise tolerance.

  • There is a family history of sudden death before age 50, related to mitral valve prolapse.

  • You have an abnormal heart rhythm (arrhythmia).

  • You have an episode of fainting (syncope).