Question Title: Echo report, MVP

I just got the echo results on my daughter. The
cardiologist said she has mitral valve prolapse with trivial regurgitation. I noticed that her left ventricle is larger than normal but he says it's ok.
The report says: Trivial mitral regurgitation, no stenosis, mild holo-systolic prolapse noted. The leaflets are thick and elongated. Trivial tricuspid and pulmonic regurgitation.
An echo she had 2 1/2 years ago was reported as normal.
She has what the cardiologist thought was a wide split second sound and he calls it a click instead and a diastolic murmur and systolic.
The numbers on the echo says: LVIDD 5.4 (3.6-5.2cm) LA 3.6 (2.1-3.7) I really worry about the LVIDD and why it's large.
Ejection fraction is 62%
Cardiac output 5.21
Cardiac index 2.93
Stroke volume 86.9

I don't have her holter monitor report but he said her only problem was sinus tachycardia (which was my concern initially as well as her frequent fainting and near fainting)

Is this ventricle size really "normal" for a 13 year old girl? And also would you mind commenting on the type of MVP that she has..is it ok for her to participate in sports?

PS... our family has a chromosome 11 abnormality (pericentric inversion) but still being studied at NIH. The primary problem is overgrowth resembling gigantism and acromegaly in the men and tall woman with premature puberty. My brother was 7'2" tall and died at the age of 28.. probably due to the morphine he was given in the hospital for pneumonia and obstructive sleep apnea "at 2am he had a pulse, at 3am he didn't". He wasn't on a cardiac monitor since his pneumonia wasn't that bad.

Sorry this was so long!!

---

________

---

Dear Chris,

Your daughter's echocardiogram report makes a finding of MVP. As in this case, mitral valve prolapse is commonly due to a redundancy and thickening of the leaflets of the mitral valve. These thickened, somewhat floppy leaflets sometimes result in the presence of significant mitral regurgitation(MR). Overall, the prognosis for mitral valve prolapse is excellent. In certain cases, such as significant MR or severely thickened leaflets, antibiotic prophylaxis is recommended prior to dental and other procedures that might increase the risk for infection of the heart valves (bacterial endocarditis). I do not think that the dizzy spells and fainting are related to your daughter's MVP. Also, the MVP alone should not influence her decision to participate in sports.

Regarding the fainting and dizziness… in young girls, an occasional faint is often a normal and benign event. Repeated episodes of loss of consciousness, especially associated with injury from falls, etc. should be further evaluated. On this note, a holter monitor was performed on your daugher. This study was entirely normal (including the sinus tachycardia). Episodes of dizziness and shortness of breath were not associated with any disorders of the heart's rhythm. This is quite reassuring, in that certain disorders of the heart's structure, such as hypertrophic cardiomyopathy, can cause disorders of the heart's thickness and rhythm. However, given the lack of either finding (on the echocardiogram or the holter monitor) it does not appear that your daughter suffers from this condition. The family history of gigantism/acromegaly is very interesting, however, and could well be associated with her MVP.

If she keeps fainting, you may want to have her undergo a study called a "tilt table test". This test helps to diagnos "common faints". If the test is positive, it would not only reassure you of a benign condition, but it would assist in suggesting some medications that might improve the problem. In any case, any young girl who faints needs to be sure to drink lots of fluids, eat regular meals, and lay down promptly if she senses an oncoming spell.

Don't worry about the ventricular size at this time. It's at the upper limits of normal. However, it may be prudent to obtain an echocardiogram in a year or two to follow this issue. If the ventricle has continued to enlarge, I would recommend a consultation with a specialist in pediatric cardiology to investigate the possible causes of this problem. Best of luck. Information in the Heart Forum is for general purposes only. Specific diagnoses and therapies are reserved for your personal physician.

---