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Posterior mitral leaflet motion in mitral stenosis.

J A Levisman, A S Abbasi, M L Pearce

    Circulation
    |March 1, 1975
    PubMed
    Summary
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    Mitral stenosis diagnosis can be challenging. Echocardiograms revealed atypical posterior mitral leaflet motion in 16 cases, but leaflet thickening and reduced atrial wave helped confirm mitral stenosis.

    Area of Science:

    • Cardiology
    • Echocardiography
    • Cardiac diagnostics

    Background:

    • Reduced diastolic closure of the anterior mitral leaflet is observed in mitral stenosis, primary pulmonary hypertension, and low left ventricular compliance.
    • Posterior motion of the posterior mitral leaflet during diastole typically rules out mitral stenosis.

    Purpose of the Study:

    • To analyze echocardiograms of patients with mitral stenosis.
    • To identify atypical cases of mitral stenosis with posterior mitral leaflet motion.
    • To determine additional echocardiographic features aiding diagnosis in these atypical cases.

    Main Methods:

    • Analysis of echocardiograms from 167 patients diagnosed with mitral stenosis.
    • Identification of cases exhibiting posterior motion of the posterior mitral leaflet.

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  • Evaluation of mitral leaflet thickening and the atrial wave in identified cases.

    • Main Results:

    • Sixteen out of 167 mitral stenosis patients (approximately 9.6%) showed posterior motion of the posterior mitral leaflet.
    • Mitral leaflet thickening was observed in these atypical cases.
    • Reduction or absence of the atrial wave was also noted in these cases.

    Conclusions:

    • Posterior mitral leaflet motion can occur in mitral stenosis, contrary to previous assumptions.
    • Mitral leaflet thickening and reduced/absent atrial wave are valuable indicators for diagnosing mitral stenosis in atypical cases with posterior leaflet motion.