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Although it is the most common congenital cardiac problem in children, mitral valve prolapse usually is asymptomatic and requires no treatment. Dr Greenwood believes, however, that if other factors, such as Marfan's syndrome, mitral regurgitation murmur, abnormalities on ECG or other tests, or chest pain or palpitations, are present, the patient should be followed closely. In this article, he groups patients according to initial symptoms and outlines diagnostic and follow-up regimens for each group.