RHD MS – MR – AR

RHD MS – MR – AR

The frame on the left side shows the domed anterior mitral leaflet, dilated left atrium and the multi-coloured (mosaic) jet of aortic regurgitation in the left ventricular outflow tract anterior to the anterior mitral leaflet. This is a diastolic frame in Colour Doppler echocardiogram. The right frame in systole shows a mosaic jet in the left atrium (dotted outline) indicating significant mitral regurgitation. The domed anterior mitral leaflet is a feature of mitral stenosis. On the whole the findings suggest mitral stenosis (MS), mitral regurgitation (MR) and aortic regurgitation (AR – marked at the most distal end of the jet, where it merges with the mitral diastolic jet of MS). Doming of the anterior leaflet in diastole occurs due to commissural fusion, characteristic of rheumatic mitral stenosis. Left atrium is dilated as a consequence of the double mitral lesion. Both images are in the parasternal long axis view, visualising the right ventricle on the top, aorta, left atrium and the left ventricle below. A portion of the interventricular septum is also seen below the right ventricle.

AR: Aortic regurgitation jet from aorta to left ventricle; Ao: Aorta; AML: Anterior mitral leaflet; LA: Left atrium; LV: Left ventricle; RV: Right ventricle; MR: Mitral regurgitation jet outlined in left atrium.