Key result
Inter-scallop separations of the posterior mitral valve leaflet can cause 'pathological' mitral regurgitation and should be excluded from the World Heart Federation 'borderline RHD' category.
Case Report (n=2)
Inter-scallop separations of the posterior mitral valve leaflet can cause isolated 'pathological' mitral regurgitation and should be recognized to avoid false-positive diagnoses of borderline rheumatic heart disease during echocardiographic screening.
May avoid false-positive borderline RHD diagnoses by excluding inter-scallop separations; challenges WHF criteria but leaves open prospective validation.
The 2012 World Heart Federation (WHF) criteria for echocardiographic diagnosis of rheumatic heart disease (RHD) identify that the finding of 'pathological' mitral regurgitation (MR) in a screened individual increases the likelihood of detecting underlying RHD. Cases of isolated "pathological MR are thus identified as 'borderline RHD'. A large-scale echocardiographic screening program (Echo in Africa) in South Africa has identified that inter-scallop separations of the posterior mitral valve leaflet (PMVL) can give rise to 'pathological' MR. The authors propose that this finding when associated with isolated 'pathological' MR is unrelated to the rheumatic disease process. In this case report, we present two examples of 'pathological' MR related to inter-scallop separation from the Echo in Africa image database. We provide additional screening tips to accurately identify this entity.
No takes yet. Share an insight, caveat, or question.
Hunter et al. (2018) conducted a case report in Rheumatic heart disease (RHD) screening / Mitral regurgitation (n=2). Inter-scallop separations of the posterior mitral valve leaflet was evaluated. Inter-scallop separations of the posterior mitral valve leaflet can cause 'pathological' mitral regurgitation and should be excluded from the World Heart Federation 'borderline RHD' category.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: