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