fig65

Figure 65. (A) Selected video frame from apical four-chamber view, demonstrating the reversal of the ventricles. In this apical four chamber view, the apex is positioned at the top, the morphologic left ventricle (LV) is placed to the right and the morphologic right ventricle (RV) is shown on the left. The right (RA) and left (LA) atria are shown at the bottom of the Figure. The attachment of the mitral valve (MV) leaflet is higher (arrow on the left) than that of the tricuspid valve (TV), indicating that the morphologic LV is on the right side and the morphologic RV is on the left side. The RA is connected to the morphologic LV and the LA to the morphologic RV. Also, note that the medial leaflet of the TV is plastered onto the ventricular septum (arrow on the right), suggesting Ebstein’s type of abnormality of the morphologic TV. (B, C) Selected video frames from a parasternal long-axis view demonstrating an aneurysm (Aneu) with the turbulent flow by color Doppler (C). Both (B) and (C) are classic parasternal long-axis views with the LA posteriorly and to the left and the LV posteriorly and to the right. (D) This frame shows a peak Doppler flow velocity of 3.5 m/s with a calculated gradient of 49 mmHg. Reproduced from Ref.^[52].