This is a systolic still-frame of the 2-dimensional echocardiogram in the parasternal long axis view from our patient. It shows an irregular mass in the left atrium that is attached to the posterior mitral leaflet and represents a vegetation. The anterior mitral leaflet is anatomically normal. The left ventricle, left atrium and aorta and the right ventricle are identified. In the real-time study that follows, note the oscillating motion of the mass as it moves into the left ventricle when the mitral valve opens in diastole and back into the left atrium as the mitral valve closes in systole. It is oblong in shape with irregular borders.
Our patient - color Doppler PLAX
This is a systolic still-frame of a color Doppler 2-dimensional echocardiogram in the parasternal long axis view from our patient. The arrows point to the outlined mitral regurgitation jet in the left atrium just behind the mitral valve. In the real-time study that follows, note that the MR jet is directed anteriorly towards the aortic root. The left and right ventricles are well seen and are normal in size and contractility.
Another patient - TEE vegetation occluding orifice
This is a systolic still-frame of a 2-dimensional transesophageal echocardiogram (TEE) at the level of the mitral valve from another patient with infective endocarditis. The arrow points to a large vegetation that appears to occlude the mitral orifice. A similar mass present on the lateral wall of the left atrium reflects a satellite vegetation. The left atrial appendage and left ventricle are identified. In the real-time study that follows, note the motion of the vegetation with systole and diastole. The mass adherent to the left atrial wall does not move with the cardiac cycle.
Another patient - TEE flail leaflet
This is a systolic still-frame of a transesophageal echocardiogram in the transverse 4-chamber plane from another patient with a flail posterior mitral leaflet secondary to ruptured chordae. This echocardiogram shows that the posterior mitral leaflet and ruptured chordae protrude into the left atrium and point away from the left ventricle towards the posterior wall of the left atrium. The arrow shows the ruptured chordae at the tip of the posterior leaflet. The non dilated left ventricle contracts normally. In the real-time study that follows, note that the posterior mitral leaflet and its attached chordae are freely mobile within the left atrium.