Rheumatic heart disease with a mitral blood cyst: three-dimensional echocardiographic imaging

A 22-year-old woman presented with a 4-month history of dyspnoea on exertion and palpitations. She was in New York Heart Association class II at presentation. She had no history of fever, joint pains or rash. On examination, she had a grade II pansystolic murmur at the apex and an early diastolic murmur at the aortic area. Laboratory investigations revealed anti-streptolysin O titre of <200 units with normal erythrocyte sedimentation rate and C reactive protein levels. On two-dimensional echocardiographic examination, the mitral valve showed mild leaflet thickening with a mobile globular cystic structure with no internal echoes (figure 1), attached to the posterior mitral leaflet, producing moderate mitral regurgitation (figure 1). The aortic valve showed leaflet thickening and retraction leading to severe aortic regurgitation. Three-dimensional echocardiographic en-face views of the mitral valve from left atrial (figure 2A, online Supplementary video 1Supplementary video 1) and left ventricular aspects (
Source: Heart Asia - Category: Cardiology Authors: Tags: Images in cardiovascular medicine Source Type: research