16yr old with MVP

  My son has distinct mitral valve prolapse, mild reguritation, with thickened leaflets, reduntant cusps ,and  trival mitral insuficitincy. His EKG also showed a mild right bundle branch block(not sure what this means). He has significant pectus excavatum which does conpress the heart and great vessels slightly and mild scoliosis. He does not use his accessory respiratory muscles.
  He is not symptomatic at this time as far as we can tell, he has mod mental retardation and is hard to tell if he understands what we ask him. What do I need to watch for, and would you put him on beta blocker, it is hard to find information for MVP in children or teenagers.
  Thanks
  Clara

[CCF CARDIO MD APS]

Dear Clara,
The current recommendations for patients with MVP and mitral regurgitation is
that they have endocarditis prophylaxis for any dental,gastrointestinal, or
urinary tract procedures.  These are areas of our body that house a lot of
microorganisms or bacteria; these bacteria if they get in the blood even for
a short period of time, can and do set up camp so to speak on any abnormal
heart valve or other structure.  We all have natural clearing mechanisms for those times
when the bacteria get in our blood (like when you go to the dentist) but we all
do not have abnormal valve structures, thus it is the general belief of the cardiologists and
infectious disease specialists that those with abnormal heart valves take antibiotics before
such procedures.  
As for the beta blocker question, in general no medicine should be prescribed
without an indication.  Although your concern is genuine regarding your child's potential
suffering you should know that most with MVP do not experience any symptoms at
all, and when they do, regardless of the degree of intelligence, it is human nature
that they complain of something (even by making funny faces as children often do
instead of outright communication.)  
The right bundle branch block finding on the ecg is just a variant of normal and is not of concern.
Remember there is a good possibility he may never have symptoms and as long as he is followed regularly
with a cardiac evaluation and or echocardiogram, there is little more to do in an aymptomatic individual with
MVP.  Information provided in the Heart Forum is intended for general informational purposes only, actual
diagnosis and treatment can only be made by your physician(s).