Triphasic mitral inflow pattern associated with hemodynamic deterioration in anemia or mitral regurgitation: a report of two cases.

We present two cases with a mid-diastolic mitral inflow peak called an "L wave" due to underlying diseases. Case 1 was an 81-year-old woman with severe anemia (hemoglobin level of 3.9 g/dL). Pulsed Doppler echocardiography showed an L wave that disappeared after transfusion of red cell concentrates. Case 2 was a 72-year-old woman with severe mitral regurgitation due to ruptured chordae tendineae. Pulsed Doppler echocardiography showed an L wave that disappeared after mitral valve repair. The present report suggests that both severe anemia and mitral regurgitation might have contributed to L wave formation, which suggests hemodynamic deterioration.