Mitral prolapse and sport

Mitral valve prolapse (MVP) is most often considered a benign condition characterized by fibromyxomatous changes in the mitral leaflets that prolapse into the left atrium with more or less severe telesystolic regurgitation. Although it is an old clinical entity, it still remains complex in terms of diagnosis and therapeutic management. Complications, such as mitral insufficiency (MI), atrial fibrillation, congestive heart failure, endocarditis, ventricular arrhythmias, and sudden cardiac death (SCD), have been noted. It is a complex pathology that could induce SCD in athletes that can be explained by the existence of fibrosis in the papillary muscles and the inferobasal left ventricular wall in the mitral valve prolapse leading to possible fatal ventricular arrhythmias. Athletes with significant MVP with MI should undergo annual evaluations including physical examination, echocardiography, stress test, and possibly magnetic resonance imaging to estimate the risk of SCD and to determine whether they are at risk for SCD.