ABSTRACT
The posterior placement of two hypertrophied papillary muscles may also cause subvalvular stenosis.14 On transgastric short axis views, the papillary muscles are obviously thickened and abnormally placed in the left ventricular cavity with a small posterior interpapillary muscle dimension. Rotation of the transducer to 90° shows the chordae to be thickened, and anomalous thick muscular bands are common. Hypoplastic papillary muscles may occur, often in groups of three or more with thickened chordae, and may cause subvalvular obstruction.15,16
CHORDAL ANOMALIES
Congenital chordal anomalies may cause mitral insufficiency or stenosis.6,14 Chordae may be fused or totally absent in congenital mitral stenosis. Chordae may be abnormally placed to the whole body of the anterior leaflet instead of just to the free edge, in a pattern similar to that of the posterior leaflet. Chordae may be elongated and may result in significant leaflet prolapse.
