Severe Hypoplasia of Posterior Mitral Valve Leaflet Presented with Atypical Chest Pain: A Case Report

Introduction: Absence of the posterior mitral leaflet is usually fatal for fetus in utero. Although hypoplasia of the posterior mitralleaflet is usually present in children with symptomatic mitral regurgitation, it is usually evident in a few cases of asymptomaticadults. We decided to introduce a rare case with hypoplasia of the posterior mitral valve leaflet associated with aortic stenosis.Case Presentation: A 24-year-old man was admittedwith a history of atypical chest pain. The patient had a normal psychophysicalgrowth. The physical examination showed 4/6 mid- systolic ejection murmurs over the left sternal border. Chest roentgenogramwas normal and the electrocardiogram showed sinus rhythm with mild LVH. Meanwhile, the echocardiography revealed severeelongated sail- like anterior leaflet and hypoplasia of the posterior mitral leaflet with moderate valvular aortic stenosis. MR gradewas mild due to the complete coverage of anterior mitral leaflet. Moreover, LV function and pulmonary arterial pressure were reportednormal.Conclusions: This abnormality was tolerated since adulthood and mitral regurgitation was gradually developed due to annulusdilation. Therefore, the posterior mitral leaflet did not have a significant impact on mitral valve performance.

Keywords:

Echocardiography , Hypoplastic Posterior Mitral Leaflet , Mitral Regurgitation