D – Mitral regurgitation
{"Image DocumentName": "D \u2013 Mitral regurgitation", "Image ImageDescription": "Answer 7. D \u2013 Mitral regurgitation. This cw doppler tracing shows a systolic ejection fraction velocity below the baseline (recorded from the apex) with a maximum velocity about 3 m/s consistent with mild aortic stenosis or without a prosthetic aortic valve. In diastole, mild aortic regurgitation is seen with a signal that starts with aortic valve closure and extends to aortic valve opening, with a maximum early diastolic velocity about 3.5 m/s and passive diastolic deceleration with a flat slope. Overlapping with the aortic regurgitant signal is a denser diastolic signal; that has a time delay between aortic closure and onset of flow, consistent with isovolumic relaxation period, indicating that this is transmitral flow. The peak velocity over 2 m/s and slightly prolonged deceleration slope suggest mild mitral stenosis or q prosthetic mitral valve , as was the case in this patient. There should be a time interval between the end of transmitral flow and aortic ejection, but this finding is obscured by a poor signal-to-noise ration. There is no atrial contribution to LV diastolic filling because this is a ventricular paced rhythm (see electrocardiogram) and the atrial rhythm likely is atrial fibrillation. This tracing does not show evidence of mitral regurgitation; a different doppler beam is needed for better evaluation of mitral valve function.", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}