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European Journal of Echocardiography 2008 9(1):69-72; doi:10.1016/j.euje.2006.08.017
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2006. For permissions please email: journals.permissions@oxfordjournals.org.

The ‘A-dip’ of diastolic mitral regurgitation: An unusual Doppler flow pattern in a patient with severe aortic insufficiency and complete heart block

Rachel Levine Berger, Edward Katz, Paul Tunick and Itzhak Kronzon*

Department of Cardiology Echocardiography Laboratory, New York University Medical Center, 560 First Avenue, New York, NY 10016, USA

Received 28 July 2006; accepted after revision 29 August 2006; online publish-ahead-of-print 7 November 2006.

* Corresponding Author. Tel: +1 212 263 5665; fax: +1 212 263 8461. E-mail address: itzhak.kronzon{at}med.nyu.edu


  Abstract

This is an unusual case of diastolic mitral regurgitation (MR) with a high diastolic velocity jet and prolonged jet duration related to a combination of acute severe aortic insufficiency and high-degree atrioventricular block. This case illustrates an interesting hemodynamic phenomenon with multiple transient decreases in the pressure gradient between the left ventricle and left atrium during diastole related to a temporary increase in left atrial pressure associated with atrial contraction.

Keywords: Diastolic mitral regurgitation; Aortic insufficiency; Atrioventricular conduction block


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