Risk of Vasovagal Syncope and Cardiac Arrhythmias in Children with Mitral Valve Prolapse

Abstract Background: Mitral valve prolapse occurs when one or both mitral valve leaflets enter the left atrium during left ventricular systole (MVP). Mitral valve prolapse is a leaflet problem. It might be primary or secondary. Presyncope and syncope in individuals with mitral valve prolapse are caused by postural, cardiac, and autonomic dysfunction (MVP). Aim of Study: The aim of this study was to determine the arrhythmia incidence and to assess the risk of vasovagal syncope in patients with MVP who had no history of syncope or near-syncope. Patients and Methods: This study prospectively studied 50 patients, who were diagnosed as MVP, according to the echocardiographic criteria of Nascimento et al., [9] between April 2020 and December 2021 at Al-Hussein Hospital Al-Azhar University, Departments of Pediatric and Cardiology. 50 age- and sex-matched healthy children were also studied as a control group. Results: There was no significant difference between study groups regarding age and sex. There was a significant difference regarding murmurs or orthostatic hypotension between the study groups. There was no significant difference between the study groups regarding Palpitation, Chest pain and drowsiness. There was a significant difference regarding incidence of Ventricular Extrasystole. There was no statistically significant difference with respect to mean QTc which was 0.39±4.5 in MVP and 0.39±5.2 in the control group (p>0.05). Conclusion: Arrhythmia and syncope frequency was found to be higher in children with MVP than in the normal popu-lation. The risk of vasovagal syncope indicated by a positive tilt test was found to be increased in children with MVP. Therefore, patients and families must be informed about the conditions that may predispose to vasovagal syncope and caution should be recommended in these patients.