![]() ![]() In 2015, the American Heart Association and the American College of Cardiology released the following recommendations regarding athletic participation in patients with mitral valve prolapse: 7 7,16 The cause of death is thought to be due to ventricular fibrillation, although a causal relationship has not been established. 10 This is probably not more frequent than the general population and occurs more often in older patients with systolic dysfunction or severe mitral regurgitation. In patients with mitral valve prolapse without mitral regurgitation, the rate of sudden cardiac death is 2 per 10,000 per year. However, there was a similar incidence of stroke between the two subtypes (7.5 and 5.8 percent). 0 percent) and eventually require mitral valve replacement (6.6 percent vs. 0 percent), moderate-to-severe mitral valve regurgitation (12 percent vs. found that those with the classic form were more likely to develop infective endocarditis (3.5 percent vs. Patients with mitral valve prolapse were classified into two groups: those with thickening and redundancy of the mitral valve leaflets ("classic") and those without ("non classic") in an attempt to identify high-risk patients. On echocardiography, mitral valve prolapse occurs when one or both leaflets protrude greater than 2 mm beyond the annulus into the left atrium during systole in the parasternal long axis and/or apical four chamber views. This may be accompanied by a systolic murmur in the presence of significant mitral valve regurgitation. The classic finding on physical exam is a mid-systolic click. 12 The majority of patients remain asymptomatic, and the diagnosis is often made incidentally on physical exam and/or echocardiogram. 14 Recent studies suggest that these symptoms do not occur more frequently in patients with mitral valve prolapse when compared to the general population. 1 Historically a mitral valve prolapse syndrome has been described as patients presented with chest pain, arrhythmias, endocarditis, transient ischemic attacks, and even autonomic instability. Mitral valve prolapse is defined as the displacement of one or both of the leaflets of the mitral valve beyond the annulus into the left atrium during systole. ![]() In this analysis, we aim to define mitral valve prolapse, identify its presentation in athletes, review physical and echocardiographic findings of this abnormality, identify high risk features and the risk of adverse outcomes, and outline consensus recommendations regarding participation of athletes in competitive sports with mitral valve prolapse and also mitral regurgitation. 13 Both participants were found to have mitral valve prolapse, generating much debate over the role mitral valve prolapse played in their deaths. Chad Schieber, a 35-year-old otherwise healthy man, and Rachael Townsend, 29, a physically fit young woman, both collapsed and died during this marathon in 20 respectively. Mitral valve disease has been a topic of particular interest in sports and exercise cardiology, gaining notoriety following the sudden cardiac death of two participants in the Chicago Marathon. 2 Mitral valve prolapse is the most common valve abnormality in the general population, affecting between 2-3% of people, and is also the most common cause of mitral valve regurgitation in athletes. There are many causes of mitral valve regurgitation, including mitral valve prolapse, infective endocarditis, rheumatic heart disease, connective tissue diseases, coronary artery disease, and dilated cardiomyopathy, among others.
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