Strict application of standard echocardiographic criteria revealed that 95% of children previously diagnosed with mitral valve prolapse were misdiagnosed, highlighting the need for improved diagnostic accuracy.
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May warrant review of prior pediatric MVP diagnoses; supports hypothesis-generating studies on echocardiographic standardization.
Objective: To determine the outcome of children referred to the paediatric cardiology unit with a previous echocardiographic diagnosis of mitral valve prolapse (MVP). Method: This study was carried out at the paediatric cardiology clinic of Teaching Hospital Karapitiya from 1st January 2012 to 31st December 2012. All children (18 years or less) presenting with a previous echocardiographic diagnosis of MVP were included in study. An echocardiographic diagnosis of MVP was reached based on the standard diagnostic criteria using an IE 33 Phillips echocardiography machine. Results: There were 141 children presenting with a previous echocardiographic diagnosis of MVP of whom 50.4% were male. Seventeen percent were below 5 years, 45% 5-9 years, 36% 10-14 years and 2% above 14 years. Of the 141, 53.2% did not have a cardiac murmur, 41.8% had a grade 2 cardiac murmur and 5% had a grade 3 murmur. Only 7 (5%) were confirmed to have MVP using standard diagnostic criteria. Of these 7 cases, 3 did not have a murmur and the remaining 4 had a grade 3 murmur best heard in the mitral area. Out of 141 subjects 57.5% had undergone 2 previous echocardiographic evaluations and 40.4% had 3-6 previous echocardiographic evaluations. Conclusion: This study shows gross over diagnosis of MVP when the standard diagnostic criteria to diagnose MVP are applied. Sri Lanka Journal of Child Health, 2013; 42(3): 144-146 (Key words: Outcome; children; echocardiographic diagnosis of mitral valve prolapse)DOI: http://dx.doi.org/10.4038/sljch.v42i3.6018
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Goonetilleke et al. (2013) studied this question.
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