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Is mitral valve prolapse a serious condition in a child?

Q: My 9-year-old son has been complaining of cold for past one year. He doesn't have a running nose. He has chest congestion. The doctor took x-ray (PA for chest), which said that there is an enlarged heart. The doctor is suspecting a hole. The doctor advised for colour doppler echocardiogram test. The observation was as follows: Mitral valve prolapse, AML mild, no mitral regurgitation, normal LV function, sinus rhythm during the study. The cardiologist advised that there is nothing to worry about. How serious is mitral valve prolapse, AML mild? Will it become more prominent as my son grows? Is it a particular defect? Is further analysis required?

A:Obviously the symptoms are unrelated to the findings on echocardiography. Many a times mitral valve prolapse is a dustbin diagnosis and needs to be confirmed by a paediatric cardiologist. Assuming that the diagnosis is correct then note 1. It can be a progressive disorder i.e. the mitral valve leak can progress although very slowly and manifest in the 4th decade of life. To document this progress (or lack of it) serial echocardiogram should be done at 1 -2 yearly intervals. 2. Rarely rapid progress can occur if the valve gets infected or some mechanical event like rupture of the valve supporting structures occur (called chordal rupture). 3. Infection if it occurs, is usually from bad orodental hygiene and therefore it is imperative to ensure regular dental check up (prevention is always better than cure) 4. Finally it is important to ensure that before any procedure in the body (like tooth extraction etc) prior antibiotic cover is mandatory. Please confirm the diagnosis from a competent authority.

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