| Case #1 | Case #2 | Case #3 | Case #4 |
Age | 27 | 17 | 28 | 22 |
Gender | Male | Male | Male | Female |
Clinical presentation |
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Duration of symptoms | 2 yrs | 1 yr | 1yr | 2 yrs |
Dyspnea | Class II | Class II | Class II | Class III |
h/o rheumatic fever in past | 12 yrs back | -- | 15 yrs back | 11 yrs back |
Rhythm | Regular | Regular | Regular | Regular |
Murmur | MDM grade IV/IV at apex, no systolic murmur | MDM grade IV/IV at apex, no systolic murmur | MDM grade II/IV at apex, no systolic murmur | MDM grade IV/IV at apex, no systolic murmur |
OS | -- | -- | + | + |
ECG | NSR, LAE | NSR, LAE | NSR, LAE | NSR, LAE |
ECHO |
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Dilated chambers | LA, RA, RV; LA size―63 × 59 mm | LA, RA, RV; LA size―62 × 53 mm | Only LA ; LA size―59 × 49 mm | Only LA ; LA size―55 × 44 mm |
Mitral valve | Double orifice, both of near equal size ? spectacle appearance | Unequal orifice, anterolateral larger | Unequal orifice, posteromedial smaller | Unequal orifice (posteromedial larger) |
Mitral valve area (MVA) cm2 | Planimerty―0.67 each | Posteromedial―0.64 anterolateral―0.45, total―1.09 | Posteromedial―0.37 anterolateral―0.57, total―0.94 | posteromedial―0.8 anterolateral―0.36 |
Mean trans-mitral gradient (mm Hg) | 16 | 12 | 11 | 11 |
MR | Trivial | No | Grade I, from posteromedial commissure | No |
PASP (TR jet) mmHg | 65 | 60 | 70 | 60 |