Thread by @jamil_tajik

Quiz for fellows and sonographers #MondayMotivation
70 year old male presenting with a systolic murmur. What is this Mitral M-mode redux of? #echofirst @AAH_StLukesCV
#cardiotwitter #ACCFIT

@MayoClinicCV @ASE360 @ACCinTouch @mahali87 @MichaelB_MD @DanielJohnsrud @ESC_Journals @AtzenhoeferM @HaroonZubairMD

Here is another clue! Hint Hint!!!

Mitral systolic flutter - a redux of an observation described in 1977 (pubmed.ncbi.nlm.nih.gov/831407/) indicative of ruptured chordal apparatus

Note the rupture chordal apparatus prolapsing and freely flailing in LA, posterior to AML as demonstrated in this video.

Note the eccentric anteromedial CF jet of MR resulting from the ruptured chordal apparatus of the posterior leaflet.

While discussing systolic fluttering of MV, how about diastolic fluttering of the AV? This M-mode observation is also a pathognomonic feature of ruptured aortic cusp (academic.oup.com/ehjcimaging/ar…)