Echocardiography in the diagnosis of rupture of chordae tendineae. Description of a clinical case

A case of ruptured chordae tendineae is reported. The patient, a 53 year old man, had a crescendo-decrescendo holosystolic murmur, a third and a fourth heart sound, that is the typical auscultatory pattern of this lesion. However, M-mode and 2-D echocardiography had a permanent role in arriving at the diagnosis. M-mode echocardiography, in fact, showed a clear systolic flutter of the mitral valve and a large anterior diastolic motion of the posterior mitral leaflet; 2-D echo, besides, revealed a quick systolic motion into the left atrium of the tip of the posterior mitral leaflet and lack of coaptation of mitral leaflet during systole. The patient underwent an operation of valve repair. At the postoperative echocardiographic examination none of the features of flail posterior mitral leaflet were found. This fact can demonstrate the success of the operation.