Posterior Mitral Valve prolapse

Images by Genevieve Carbonatto

Parasternal long axis view, (PLAX)  of the left ventricle showing bileaflet mitral valve prolapse, (MVP) but much more prominent in the posterior leaflet. The PLAX is used to diagnose MVP, if the parasternal window is able to be used.

Parasternal long axis view, (PLAX)  of the left ventricle showing bileaflet mitral valve prolapse, (MVP) but much more prominent in the posterior leaflet with colour flow imaging across the valve. Note that there are two jets of mitral regurgitation, (MR) occuring during systole when the mitral valve should be closed.  The posterior MVP causes an anteriorly directed jet of MR, (directed towards the probe) therefore is  a red jet with aliasing yellow and white.  The second jet of MR is more centrally directed, caused by the anterior and posterior MVP. The jet is away from the probe so is blue.

Parasternal short axis at the level of the mitral valve leaflet tips.

Parasternal short axis at the level of the mitral valve leaflet with colour across the valve. Note the posterior valve prolapse in the 2D image with the colour jet laterally.

Parasternal short axis at the level of the left ventricular outflow tract demonstrating mainly the anterior mitral valve leaflet  with a significant amount of redundant tissue.  The posterior leaflet is not well seen at this level.

Apical 4-chamber view with colour across the mitral valve. The anterior direction of the jet is displayed.  To assess the full length and direction of the anteriorly directed jet, the colour box should be opened a little more in both width and length.  We need to visualise the PISA dome of the jet and its full length to the pulmonary veins.

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