FIGURE LEGENDS:
Fig 1 – M mode of the mitral valve (MV) shows systolic anterior motion
of the mitral valve (marked with blue arrow) and contact with the
interventricular septum (IVS)
Fig 2 – Shows typical facial features of Noonan syndrome like broad
forehead, hypertelorism,low set ears, bulbous tip of the nose and cupid
bow upper lip
Fig 3 – Apical 4 chamber view (LA-left atrium, LV-left ventricle,
RA-right atrium, RV-right ventricle) - Red arrow shows myxomatous mitral
valve, blue arrows shows hypertrophied basal interventricular septum,
green arrow and green star show membranous septal aneurysm (AN)
Fig 4 – Continuous wave doppler of the left ventricular outflow tract
shows severe left ventricular outflow tract obstruction with a peak
gradient of 100 mm Hg
Video 1 – Modified parasternal long axis shows myxomatous mitral valve,
moderate mitral regurgitation into the left atrium (LA), systolic
anterior motion of the mitral valve, hypertrophied basal
interventricular septum (IVS) and resultant turbulence in the left
ventricular outflow tract and Aorta (AO)
Video 2 – Apical 4 chamber view shows membranous septal aneurysm (AN)
protruding into the right ventricular inflow region and absence of any
ventricular septal defect (LA-left atrium, LV-left ventricle, RA-right
atrium, RV-right ventricle)
Video 3 – Simultaneous 2D and colour imaging show contact of myxomatous
mitral valve (AML) and hypertrophied basal interventricular septum (IVS)
with resultant jet directed towards the membranous septal aneurysm (AN),
absence of right ventricular inflow turbulence and absence of
communication with the right ventricle