Which pairing is incorrect?

Which pairing is incorrect?

• A. Anterior leaflet prolapse — MR jet directed posteriorly
• B. Posterior leaflet prolapse — MR jet directed anteriorly
• C. Both leaflets prolapse — MR jet directed centrally
• D. Anterior leaflet prolapse — MR jet directed anteriorly

Answer: (D)

In mitral regurgitation, the direction of the regurgitant jet on echocardiography reflects which leaflet is prolapsing. Anterior leaflet prolapse tends to produce a jet directed toward the posterior left atrium, while posterior leaflet prolapse tends to produce a jet directed toward the anterior left atrium. If both leaflets prolapse, the jet is typically central. Therefore, pairing anterior leaflet prolapse with a jet directed anteriorly is incorrect, because that combination contradicts the usual jet direction pattern. The other pairings fit the typical patterns: anterior leaflet prolapse with a posterior-directed jet; posterior leaflet prolapse with an anterior-directed jet; and both leaflets prolapsing with a central jet.

In mitral regurgitation, the direction of the regurgitant jet on echocardiography reflects which leaflet is prolapsing. Anterior leaflet prolapse tends to produce a jet directed toward the posterior left atrium, while posterior leaflet prolapse tends to produce a jet directed toward the anterior left atrium. If both leaflets prolapse, the jet is typically central.

Therefore, pairing anterior leaflet prolapse with a jet directed anteriorly is incorrect, because that combination contradicts the usual jet direction pattern. The other pairings fit the typical patterns: anterior leaflet prolapse with a posterior-directed jet; posterior leaflet prolapse with an anterior-directed jet; and both leaflets prolapsing with a central jet.