Echocardiographic diagnosis of mitral valve aneurysm

Cases of mitral valve aneurysm determined during the patient's lifetime have not yet been described in literature. Using a mechanical sector scanner we were able to diagnose a mitral valve aneurysm in a 22-yr-old man suffering from rheumatic aortic steno-insufficiency. The real-time, cross-sectional image showed an aneurysm which was limited to the proximal part of the anterior mitral leaflet. During diastole the reflow of blood from the insufficient aorta determined an enlargement of the aneurysm towards the left atrial cavity. Bacterial vegetation which protruded from the aortic valvular surface and which was responsible for abnormal echoes in the M-mode in the left outflow tract was also detected. The patient died of irreversible cardiac insufficiency caused by the infectious endocarditis, and upon autopsy the echocardiographic diagnosis was confirmed.