Figure 33-4 Severe mitral regurgitation with a wall-hugging jet. This honed-down five-chamber echocardiogram reveals severe mitral regurgitation. The long color jet has a fairly broad base and an eccentric direction indicative of severe mitral regurgitation. Wall-hugging jets such as this one have a small cross-sectional area because much of their energy is absorbed by the wall of the atrium. The mechanism of the regurgitation is apparent: the anterior leaflet (on the left side of the video screen) is prolapsing and allowing blood to escape beneath it and jet over the surface of the posterior leaflet into the left atrium (LA). LV, left ventricle; MV, mitral valve. (From Cahalan MK: Intraoperative Transesophageal Echocardiography. An Interactive Text and Atlas. New York, Churchill Livingstone, 1997.)