Pediatric Mitral Valve Prolapse Differential Diagnoses

Updated: Mar 21, 2017
  • Author: Poothirikovil Venugopalan, MBBS, MD, FRCPCH; Chief Editor: Syamasundar Rao Patnana, MD  more...
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DDx

Diagnostic Considerations

Important considerations

Note the following:

  • Do not fail to make the diagnosis

  • Do not fail to fully investigate patients who are symptomatic

  • Restrict exercise in patients who are symptomatic

  • Recognize the higher risk of arrhythmia during anesthesia and the perioperative period

  • Properly interpret findings: Patients with mitral valve prolapse (MVP) syndrome require a careful history and thorough physical examination because of the possibility of misinterpreting history, physical findings, borderline laboratory test results, and nonspecific electrocardiographic (ECG) or echocardiographic changes.

  • Avoid overtreatment

Special concerns

The diagnosis should include the type of prolapse (late systolic, holosystolic, anterior, or posterior leaflet), thickness of mitral valve leaflets, size of mitral annulus, and the left ventricular and left atrial size and function. The diagnosis should also include presence, severity, and timing of mitral regurgitation (MR); define jet direction and magnitude; and clearly list associated abnormalities.

Patients with orthostatic syncope secondary to dehydration should take excess salt and water during and following sport activities and competition.

Patients are more sensitive to volume depletion; hence chronic diuretic therapy should be avoided.

Other problems to be considered

Also consider the following conditions in patients with suspected mitral valve prolapse:

  • Congenital mitral regurgitation

  • Rheumatic mitral regurgitation

  • Tricuspid valve prolapse

Differential Diagnoses