Association between the severity of chest pain and the severity of mitral valve prolapse in children

authors:

avatar Saman Gudarzi , avatar Elham Farahani , avatar Parsa Yousefichaijan , avatar Nooshin Sadjadei , avatar Yazdan Ghandi ORCID , *

Koomesh: Vol.24, issue 1; 78-83
published online: March 02, 2022
article type: Research Article
received: November 03, 2020
accepted: August 02, 2021

how to cite: Gudarzi S, Farahani E, Yousefichaijan P, Sadjadei N, Ghandi Y. Association between the severity of chest pain and the severity of mitral valve prolapse in children. koomesh. 2022;24(1):e154088. 

Abstract

Introduction: One of the causes of chest pain in children is mitral valve prolapse (MVP). This study aimed to investigate the association between the severity of chest pain and the severity of MVP. Materials and Methods: This cross-sectional study was designed on 103 children aged 7 to 18 years suffering from MVP along with chest pain. By using echocardiography, severity of MVP was assessed in all the subjects by two cardiologists, separately. According to the echocardiography criteria, the severity of MVP was divided into three types: grade I, II and III. The severity of chest pain was assessed according to visual analog scale (VAS) criteria (Mild, Discomfortable, Distressing, Horrible, and Excruciating). Results: The mean age of the 103 patients with MVP was 11.76±2.85 years (F/M: 66/36). The most common site of pain was the left side of the chest. Mitral valve insufficiency was diagnosed in 76 children. Respectively, 31 children suffered from mild type, 58 moderate and 13 severe MVP. 74.51% of children had MVP along with mitral valve insufficiency. A total of 33 children described their pain as excruciating 8 of whom had severe MVP. The mean severity of chest pain according to VAS criteria in children with severe MVP was 7.92±1.03, which was significantly higher than moderate and mild (P=0.000). Conclusion: There was a positive association between the severity of chest pain and severity of MVP in children. Therefore, it seems that attention to chest pain in children with MVP could be useful to evaluate the severity of MVP

References

  • 1.

    Drossner DM, Hirsh DA, Sturm JJ, Mahle WT, Goo DJ, Massey R, et al. Cardiac disease in pediatric patients presenting to a pediatric ED with chest pain. Am J Emerg Med 2011; 29: 632-638. https://doi.org/10.1016/j.ajem.2010.01.011 PMid:20627219.

  • 2.

    Chun JH, Kim TH, Han MY, Kim NY, Yoon KL. Analysis of clinical characteristics and causes of chest pain in children and adolescents. Korean J Pediatr 2015; 58: 440-445. https://doi.org/10.3345/kjp.2015.58.11.440 PMid:26692880 PMCid:PMC4675925.

  • 3.

    Ghandi Y, Mehrabi S, Nariman R, Habibi D. Evaluation of clinical manifestation, demographics parameters and causes of chest pain in children. Int J Pediatr 2020; 8: 12409-12419.

  • 4.

    Hanson CL, Hokanson JS. Etiology of chest pain in children and adolescents referred to cardiology clinic. WMJ 2011; 110: 58-62.

  • 5.

    Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J 2005; 26: 319-338. https://doi.org/10.1183/09031936.05.00034805 PMid:16055882.

  • 6.

    Delling FN, Vasan RS. Epidemiology and pathophysiology of mitral valve prolapse: new insights into disease progression, genetics, and molecular basis. Circulation 2014; 129: 2158-2170. https://doi.org/10.1161/CIRCULATIONAHA.113.006702 PMid:24867995 PMCid:PMC4052751.

  • 7.

    Levine RA, Jerosch-Herold M, Hajjar RJ. Mitral valve prolapse: a disease of valve and ventricle. J Am Coll Cardiol 2018; 72: 835-837. https://doi.org/10.1016/j.jacc.2018.07.006 PMid:30115221 PMCid:PMC6168064.

  • 8.

    Levine RA, Durst R. Mitral valve prolapse: a deeper look. JACC Cardiovasc Imaging 2008; 1: 304-306. https://doi.org/10.1016/j.jcmg.2008.04.003 PMid:19225572 PMCid:PMC2643371.

  • 9.

    Ghandi Y, Ghahremani B, Habibi D, Pouya A, Sadrnia S. Assessment of transmural dispersion of repolarization in children with mitral valve prolapse. J Tehran Univ Heart Center 2020; 15: 64. (Persian). https://doi.org/10.18502/jthc.v15i2.4185 PMid:33552196 PMCid:PMC7825468.

  • 10.

    Peighambari MM, Alizadehasl A, Totonchi Z. Electrocardiographic changes in mitral valve prolapse syndrome. J Cardiovasc Thorac Res 2014; 6: 21-23.

  • 11.

    Mina Amirimoghadam Z. Prevalence of mitral valve prolapse in children with chest pain. J Mazandaran Univ Med Sci 2015; 24: 375-378. (Persian).

  • 12.

    Rokicki W, Krzystolik-Ladziska J, Goc B. Clinical characteristics of primary mitral valve prolapse syndrome in children. Acta Cardiol 1995; 50: 147-153.

  • 13.

    Sattur S, Bates S, Movahed MR. Prevalence of mitral valve prolapse and associated valvular regurgitations in healthy teenagers undergoing screening echocardiography. Exp Clin Cardiol 2010; 15: e13-e15.

  • 14.

    Warth DC, King ME, Cohen JM, Tesoriero VL, Marcus E, Weyman AE. Prevalence of mitral valve prolapse in normal children. J Am Coll Cardiol 1985; 5: 1173-1177. https://doi.org/10.1016/S0735-1097(85)80021-8.

  • 15.

    Cada DN, Pa FA. Cardiac chest pain in children. Anadolu Kardiyol Derg 2009; 9: 401-406.

  • 16.

    Malakan Rad E, Momtazmanesh N. Evaluation of the incidence of mitral valve prolapse in 50 neonates and children in Shahid Beheshti University in Kashan. Feyz 2001; 5: 38-43 (Persina).

  • 17.

    Movahed MR, Hepner AD. Mitral valvar prolapse is significantly associated with low body mass index in addition to mitral and tricuspid regurgitation. Cardiol Young 2007; 17: 172-174. https://doi.org/10.1017/S1047951107000108 PMid:17291393.

  • 18.

    Samim H, Hosseini S, Jalalyazdi M. Evaluation of the relationship between mitral valve prolapse (MVP) and body mass index (BMI): a review article. Bali Med J 2016; 5: 57-63. https://doi.org/10.15562/bmj.v5i3.301.

  • 19.

    Selbst SM, Ruddy RM, Clark BJ, Henretig FM, Santulli T, Jr. Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319-323. https://doi.org/10.1542/peds.82.3.319 PMid:3405660.