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03-Sep-2026
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Professor Simon Meagher and Professor Ritsuko Pooh Performing Ultrasound Examinations Using the Voluson E22 System
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The same valve, the same ultrasound screen—yet they can tell three completely different stories.
Video source: Dr. Shubham
This video illustrates the appearance of the mitral valve in three different conditions: a normal mitral valve, rheumatic heart disease (RHD), and mitral valve calcification.
At first glance, the images may appear quite similar. However, from a clinical perspective, each condition has its own distinctive features and carries different diagnostic implications.
Normal Mitral Valve
The valve leaflets are thin, pliable, and move freely during opening and closure. Blood flow across the valve is typically smooth and relatively uniform on color Doppler imaging. This reflects a valve that is functioning efficiently and working in coordination with the heart.
Rheumatic Mitral Valve Disease
The valve leaflets may become thickened, particularly at the tips, with restricted mobility and a characteristic appearance often described as “hockey-stick” deformity. Blood flow across the valve may become turbulent as a result of mitral stenosis, regurgitation, or a combination of both.
These changes can develop as long-term consequences of rheumatic heart disease and may affect valve function for many years.
Mitral Valve Calcification
On ultrasound, calcified areas typically appear highly echogenic, particularly around the mitral annulus. Calcification reduces the flexibility of the valve apparatus and may alter blood flow across the valve.
This is commonly associated with degenerative changes over time and may also be related to various metabolic and cardiovascular factors.
Key Takeaways
Rheumatic valve disease primarily causes thickening, fibrosis, and scarring of the valve leaflets and associated structures. Mitral annular calcification alters the structure and flexibility of the valve annulus. In contrast, a normal mitral valve remains thin, flexible, and mobile, allowing blood to flow efficiently.
Distinguishing between these conditions is important for disease assessment, prognosis, and determining the most appropriate approach to follow-up or treatment.
Echocardiography is not simply about producing images. It combines structural recognition, blood-flow assessment, and clinical reasoning.
Xem video 
Vivid Echocardiography System
The images were acquired using the Vivid cardiovascular and general imaging ultrasound system by GE HealthCare.
Video source: Dr. Shubham
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