M-mode echocardiogram of mitral stenosis

The normal mitral valve, the anterior (aML), and posterior leaflets (pML) are seen in panel A; the e-f slope is normal. The valve thickness, as demonstrated between the arrows, is not increased. Panel B is the M-mode echocardiogram of a severely stenotic mitral valve; the e-f slope is reduced, atrial contraction (a wave) is dimunitive, and the valve thickness is increased (between arrows). The simultaneous phonocardiogram demonstrates a short interval (0.9 sec) between the second sound and opening snap (OS) and a presystolic low-frequency murmur resulting from atrial contraction.