Hi, Thanks for writing in. Remember that training demands vary considerably even within the same sport. The demands of competitive sports may place athletes with certain cardiovascular abnormalities in extreme or unpredictable environmental conditions. These can be associated with alterations in blood volume and in hydration and electrolyte levels, circumstances which could enhance the risk of potentially lethal arrhythmias. However, because Mitral Valve Prolapse (MVP) is common, it has been associated with a myriad of conditions that probably do not have anything to do with the MVP itself. While it is commonly believed that MVP causes chest pain and heart palpitations, most individuals with MVP do not experience them. It is not at all clear that mild MVP is in any way associated with sudden death, let alone a cause of it. A small number of patients with MVP will eventually develop significant Mitral Regurgitation (MR), which in turn can produce heart muscle weakness—and these patients do have an increased risk of life threatening arrhythmias. This is why it is vital to distinguish MVP from MR, even if the one can occasionally cause the other. Patients with severe mitral regurgitation—from any cause—have an increased risk of stroke and sudden death, but the vast majority of patients with MVP have never been shown to have any higher risk of sudden death than the general population, and the recent tragedies in Chicago should not cause undue concern. If you do have MVP, make sure you understand from your physician the degree of MR that you have. It’s also important that your doctor has a schedule for outlining and monitoring this degree over time. If you have chest pain or palpitations, these symptoms ought to be evaluated as separate entities. Bikram yoga is an intense session of yoga at high temperatures which may cause fluid and electrolyte imbalance. This must be kept in mind and precautions taken in case of discomfort. Hope this helps