Echocardiogram in parasternal long axis (PLAX) view in mitral stenosis (MS). The anterior mitral leaflet is seen to be domed, with a hockey stick appearance. The posterior mitral leaflet moves anteriorly instead of the normal posterior movement (paradoxical motion). Both these abnormalities are a consequence of commissural fusion in rheumatic mitral stenosis. Left atrium is dilated as a sequelae of mitral stenosis or associated mitral regurgitation which can only be documented by Doppler (either color Doppler or continuous wave Doppler). Fair diastolic separation of the tips of mitral leaflets indicate that the mitral stenosis is unlikely to be severe. Hence the left atrial dilatation is likely to be due to significant mitral regurgitation.
Ao: Aorta; LA: Left atrium; AML: Anterior mitral leaflet; PML: Posterior mitral leaflet; LV: Left ventricle; RV: Right ventricle.