Diastolic mitral gradient without associated valvular stenosis: usefulness of two-dimensional echocardiography for a correct diagnosis.

A diastolic gradient across the mitral valve is generally indicative of mitral valve stenosis. In the present study, echocardiography was used to demonstrate two less common causes of left ventricular inflow obstruction: one patient had a fibromuscular membrane beneath the valve, the other a large vegetation attached to the posterior leaflet of the mitral valve. Echocardiography proved to be the optimal imaging technique in each case.