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12 year-old female athlete with mitral annular disjunction

Daniel Neunhaeuserer, Sports Cardiology Quiz Section Co-Editor

Rehabilitation and Sports Cardiology
Risk Factors and Prevention

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. 

Test your knowledge

Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material on the site are only examples and do not guarantee outcomes from formal examinations.


The references for this case are available in the explanation text of the MCQ's. 

Notes to editor

Authors information:

Prof. Dalle Carbonare, Luca, Verona University, Director of the Graduate School of Sport Medicine and Exercise, Dpt. Of Medicine

Dr. Posenato, Chiara, S. Bonifacio Hospital, Dpt. Of Prevention

Dr. Bertaiola, Mariano, Verona University Hospital, Dpt. Of Orthopedy

Dr. Dalle Carbonare, Chiara, Verona University Hospital, Dpt. Of Medicine