Mitral valve prolapse, affecting ~5% of the population, generally has a favorable prognosis allowing competitive athletics, though disqualification is advised for those with high-risk features.
Should athletes with mitral valve prolapse be allowed to participate in competitive athletics?
Athletes with mitral valve prolapse can generally participate in competitive sports, but should be disqualified if they have high-risk features like syncope, complex arrhythmias, or significant mitral regurgitation.
Mitral valve prolapse is probably the most common cardiac valve disorder, affecting approximately 5% of the population. Although it is genetically determined, its clinical manifestations do not usually become evident before adulthood. In the setting of a cardiology referral center, a mitral valve prolapse syndrome, consisting of nonspecific symptoms, repolarization changes on the electrocardiogram and arrhythmias, has been identified. However, doubt has recently been expressed about the existence of such a syndrome. The prognosis of mitral valve prolapse is generally favorable but infrequent complications do occur and include transient ischemic attacks, progression of mitral regurgitation with or without ruptured chordae tendineae, infective endocarditis and sudden death. The symptoms and the complications are not usually related to physical activity. A permissive attitude toward participation of patients with mitral valve prolapse in competitive athletics is probably warranted; however, it would appear reasonable to disqualify athletes with mitral valve prolapse in the following circumstances: history of syncope; disabling chest pain; complex ventricular arrhythmias, particularly if induced or worsened by exercise; significant mitral regurgitation; prolonged QT interval; Marfan's syndrome; and family history of sudden death.
Robert M. Jeresaty (Wed,) conducted a review in Mitral valve prolapse. Competitive athletics participation was evaluated. Mitral valve prolapse, affecting ~5% of the population, generally has a favorable prognosis allowing competitive athletics, though disqualification is advised for those with high-risk features.