Clinical and echocardiographic characteristic of mitral valve chordae rupture.

In 23 patients with mitral valve chordae rupture, the diagnostic sensitivity, specificity and predictive accuracy of various changes found by one-dimensional echocardiography (M-echo) were determined. Nearly all M-echo changes have a relatively low sensitivity (10-50%), high specificity (80-100%) and moderate predictive accuracy (30-80%). Greater diagnostic value--moderate sensitivity, high specificity and greater predictive accuracy--is shown by the following changes: systolic mitral valve flutter, diastolic mitral leaflets flutter, paradoxical (chaotic) movement of the posterior mitral leaflet in diastole. Of very low sensitivity (10%) but high specificity (100%) are pathological systolic echo-signals in the left atrial cavity.