Podiatry residents today are much better trained in the non podiatric core than I was. I believe this to be a good thing. Every now and then, actually often, I have questions relating to medicine that are non podiatric related.

I have one now - and figured I would ask. Why not test the old axiom that "no question is a stupid question". I have a patient who is avid jogger. He presents to me every so often for subungual hematoma to an elongated second toe.

My question is he has a history of mitral valve prolapse. Other than knowing their is a debate of whether one needs to be needs to be prophylaxed with antibiotics with a history of mitral valve prolapse this is the extent of my knowledge on the topic.

Would jogging/overexertion be in any way contraindicated in a patient with mitral valve prolapse? I could start googling all about mitral valvae prolapse but figured why not start an interesting topic on non-podiatric medicine that we see in our office daily.

Perhaps, we could improve our general medicine knowledge in this way...

  • Comments (5)
  • Carla - if I am not mistaken, I thought that MVP does not require prophylaxis anymore.
    Which, doesn't really matter for me when performing surgery as hospitals by mandate prophylaxis for everyone.
    I don't think cuts would require prophylaxis. (My opinion).,,unless there was infection.....
  • Here's another related question.  I know there's a lot of literature regarding surgical prophylaxis and MVP, but what about injury in general.  If a patient with MVP cuts their foot, stubs their toe, or for that matter injures themselves in any way (breaks the skin), there are plenty of bacteria that can seed the valve.  They may be gardening and get a little cut on a finger.  Most of us rinse off minor injuries and may even put a bandage with topical antibiotic on it.  Do people with MVP have to go on antibiotics for minor open injuries?  If the idea is that bacteria can seed the valve, then theoretically even a small cut would be reason for concern, more so than a needle prick under semi-sterile conditions.  I've never heard or read anything about MVP prophylaxis after an open skin injury.

     

  • Dr. Bates you make a good point with regards to the patient having his own stress test.

    I found this:" Upper body exercise, particularly isometric exercise such ad weight lifting, nautilus machines etc...tend to increase the symptoms in patients with Mitral Valve Prolapse Syndrome. Tennis is primarily an aerobic activity which is recommended for patients with MVPS. Although tennis involves some upper extremity movement it is still primarily aerobic and is an excellent way of exercising if you have MVPS. Of course other types of exercise such as aerobic dancing or jazzercise, zumba, walking, jogging and swimming are all alternative forms of aerobic exercises. Remember, however, to be sure that you have adequate fluid intake any time you exercise."

    I tool this off a website by Phillip C Watkins MD He is the Direector and co-founder of the Autonomic disorders and mitral valve prolapse center.
    It was an answer to a similiar question asked by a person asking if it was okay for them to play tennis.


  • This avid jogger has been performing exercise stress test on him self every time he runs.  Zier's  discussion of mitral valve prolapse concerns prophylactic antibiotics for surgery, but no mention of danger of physical exercise.