Mitral valve disease

Transthoracic parasternal long-axis view echocardiogram recorded in a patient

with rheumatic heart disease and mitral stenosis. In this image, recorded in early
diastole, note the doming motion of the anterior mitral valve leaflet with
restriction of motion at the tips. The belly of the leaflet (arrows) is pliable, and
there is little or no fibrosis, calcification, or thickening of the leaflets. Also note the
secondary dilation of the left atrium (LA). In the real-time image, note the
relatively fixed position of the leaflet tips with all motion of the leaflet occurring at
the mid and proximal portions of the leaflets. LV, left ventricle; RV, right ventricle.
Apical four-chamber view recorded in a patient with rheumatic mitral stenosis.
Note the marked dilation of the left atrium (LA). In this example, there is
substantial but focal calcification of the anterior mitral valve leaflet (arrow). Note
also the relatively restricted motion of both leaflets along their full length. LV, left
ventricle; RA, right atrium; RV, right ventricle.
Expanded parasternal long-axis view recorded in a young
patient with congenital mitral stenosis. Note the abnormal
position of chordae to the posterior mitral leaflet (arrow),
which restricts its motion, resulting in mitral stenosis. Ao,
aorta; LA, left atrium; LV, left ventricle.
Series of parasternal short-axis views recorded in a patient with rheumatic
mitral stenosis. A: Recorded at the actual restrictive orifice, and the mitral
valve area (MVA) can be planimetered at 0.9 cm2. B–D: The three
additional views were recorded progressively closer to the anulus and
show a progressive increase in the planimetered mitral orifice depending
on the position at which the “orifice” is planimetered.