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Case of trileaflet mitral valve: an important differential for non-classical intracavitary gradient in suspected hypertrophic cardiomyopathy
  1. Joseph Barker,
  2. Neil Silverwood and
  3. Robert Gerber
  1. Department of Cardiology, Hawkes Bay Hospital, Hastings, New Zealand
  1. Correspondence to Dr Joseph Barker, joseph.barker{at}


There are nine published reports of trileaflet mitral valves globally. As such their implication on health outcomes and associations with other disease is uncertain. This case describes a 62-year-old man presenting with exertional dyspnoea and hypertension. It describes an early misdiagnosis of hypertrophic cardiomyopathy and highlights that clinicians should be alerted in cases of very high left ventricular outflow gradients in the presence of eccentric mitral regurgitation (MR). Here the MR was caused by a rare congenital deformity whereby a deep cleft in the posterior leaflet resulted in a tricuspid appearance. We present the natural disease course of a trileaflet mitral valve and without intervention over 13 years from symptom onset to the development of severe MR.

  • valvar diseases
  • interventional cardiology
  • clinical diagnostic tests
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  • Contributors This article was primarily authored by JB under the supervision of RG and NS who were critical to the conception and design of the work, image acquisition and interpretation as well as revisions to drafts. Each author approved the final approval of the version submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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