The detection of mitral stenosis has been a classic application of echocardiography. The technique utilizes the recording of an echo from the anterior leaflet of the mitral valve. A reduced diastolic slope is the principal criterion for the diagnosis of mitral stenosis. Several investigators have noted that a similar pattern of mitral valve motion can occur in patients without mitral stenosis. This study shows how the recording of the posterior leaflet of the mitral valve can help alleviate this confusion. Anterior and posterior mitral valve echograms were obtained in normal subjects, patients with mitral stenosis proved at cardiac catheterization, and patients with abnormal anterior mitral valve motion but no evidence of mitral stenosis at catheterization. The results demonstrate that in normal persons the posterior and anterior leaflets move in virtually opposite directions. In patients with true mitral stenosis the leaflets move in essentially the same direction but to a different degree. In patients with an abnormal diastolic mitral valve motion, possibly due to reduced rates of left ventricular filling, the posterior leaflet moves in a direction opposite to that of the anterior leaflet. Thus, this study can clearly distinguish these patients from those with true mitral stenosis.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine