Valvular HD

Case 178: Double or Triple Trouble

It is important to know how to pick up subclinical rheumatic mitral valve disease and how to characterize further a bicuspid aortic valve.

Bhavin Jankharia

Feb 6, 2025 — 2 min read

A 58-years old patients was referred for work-up. She had one episode of failure 3 years ago and echo shows multiple findings, then and now.

CMR showed a dilated cardiomyopathy with normal T1, T2 maps and no LGE.

It also showed a "hockey-stick" appearance of the anterior mitral valve leaflet and a subtle "fish-mouth". This suggested subclinical rheumatic involvement of the mitral valve

There was also a bicuspid aortic valve with aortic stenosis.

The video below explains the case, the importance of picking up rheumatic MV disease on CMR and how to characterize bicuspid AVs and what the cause of the DCM may be.

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