Q: My daughter drashti aged 13 years had typical chest pain and palpitation and on examination cardiologist found her to be a patient of MVP. He performed 2D echo and findings are : Mormal LV function 0.73% The Mitral valve were bulky redundant and exhibited grade II late systolic prolapse pattern. Doppler interrogation revealed Trivial Mitral Regurgitation Normally functioning aortic,pulmonary and tricuspid valves Interventicular and interatrial septum were intact No I/C clot Her Hb is 12% Throid function within normal limits. Her heart size is normal. Cardiologist has suggested IE Prophylaxix INDERAL 40 1/2 1/2 1/2 Daily No restriction of physical activity Weight is 55 kg. lungs clear. S1- present A2- + Kindly guide me as whether there is any major problem to my daughter and whether any precautions to be observed what is the significance of IE prophylaxis. Does it suggest any future treatment. Her class room is on 3rd floor with 40 steps. she goes to class by cycling. Please explain to me as to any future complications or surgical intervention at a later date or is there any life threatening condition in future ?

A:This is a well recognised entity and looking at the echo report I don't think that any sort of activity restriction is required, I would personally not give Inderal unless we can show that the palpitation is due to a Paroxsysmal atrial tachycardia which can be associated with this condition. I would get a 24 hour Holter test for this. many of the palpitation are also pshycosomatic. IE prophylaxis is to prevent the valve getting infected. This occours only if there is mitral regurgitation. I am not sure from this report whether this mitral regurgitation is pathological or physiological. most of these infection spread from bad dental hygeine so adequate care has to taken. A regular visit to a dendist is worth the trouble as PREVENTION IS ALWAYS BETTER THAN CURE. Also when any procedures is performed on the patient, the concerned doctor need to be informed.