12 year-old female athlete with mitral annular disjunction

The case

A 12-year-old female Caucasian athlete came to our institution to attend a pre-participation screening for competitive athletic sports eligibility:

• Her family history was negative for sudden cardiac death (SCD), ischemic heart disease, or cardiomyopathies
• Her mother was diagnosed with a mild mitral valve prolapse (MVP)
• No personal history of pre-syncope or syncope was reported

In the context of a transthoracic echocardiogram, required for the finding of a grade 2/6 proto-midsystolic murmur during a routine pediatric exam, the athlete was diagnosed with:

• MVP, mitral-annular disjunction (MAD) (10 mm)
• Associated with a mild mitral regurgitation

In her recent medical history, she reported an occasional feeling of exercise-independent cardiac palpitations.