How valve shape relates to diagnosis of mitral valve prolapse

This graphic shows the way the saddle-like shape of the mitral valve – if not clearly understood – can lead to an erroneous diagnosis of mitral valve prolapse. The views on the left are cutaways of the left side of the heart, showing the mitral valve (shaded area) on top of the left ventricle (LV). The mitral valve controls the flow of blood between the left atrium (LA), the chamber that receives oxygenated blood from the lungs, and the left ventricle, the main pumping chamber that sends blood out into the body through the aorta (Ao).

The views on the top show how a front-to-back ("long axis") echocardiographic view (dotted line) produces a picture of the valve showing a depression in the center (darkened area on figure at top right), the shape that was believe to reflect a normal valve. The views at the bottom show how echocardiograms that produce side-to-side ("four-chamber") views of the valve (dotted line) can produce a picture (darkened area) that looks like the valve is bulging up above the area at which it attaches to the heart walls. This image previously would have been interpreted as showing mitral valve prolapse. New understanding of the valve's real shape allows physicians to recognize this as a normal valve.

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