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Prominent inter-scallop separations of the posterior leaflet of the mitral valve: an important cause of ‘pathological’ mitral regurgitation.

Prominent inter-scallop separations of the posterior leaflet of the mitral valve: an important cause of ‘pathological’ mitral regurgitation.
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Hunter LD, Monaghan M, Lloyd G, Pecoraro AJK, Doubell AF, Herbst PG,


Hunter LD, Monaghan M, Lloyd G, Pecoraro AJK, Doubell AF, Herbst PG, (click to view)

Hunter LD, Monaghan M, Lloyd G, Pecoraro AJK, Doubell AF, Herbst PG,

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Echo research and practice 2018 03 23() pii ERP-18-0010
Abstract

The 2012 World Heart Federation (WHF) criteria for echocardiographic diagnosis of rheumatic heart disease (RHD) identify that the finding of ‘pathological’ mitral regurgitation (MR) in a screened individual increases the likelihood of detecting underlying RHD. Cases of isolated "pathological MR are thus identified as ‘borderline RHD’. A large-scale echocardiographic screening program (Echo in Africa) in South Africa has identified that inter-scallop separations of the posterior mitral valve leaflet (PMVL) can give rise to ‘pathological’ MR. The authors propose that this finding when associated with isolated ‘pathological’ MR is unrelated to the rheumatic disease process. In this case report, we present two examples of ‘pathological’ MR related to inter-scallop separation from the Echo in Africa image database. We provide additional screening tips to accurately identify this entity.

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