If both leaflets prolapse, the MR jet angle is directed:

If both leaflets prolapse, the MR jet angle is directed:

• A. Posteriorly
• B. Centrally
• C. Anteriorly
• D. Inferiorly

Answer: (B)

When the regurgitation comes through a central orifice, the jet travels straight into the middle of the left atrium. Bileaflet prolapse creates a regurgitant orifice that is effectively midline, so the MR jet is directed centrally. In contrast, a single leaflet prolapse tends to push the jet toward the side opposite that leaflet (posterior-directed if the anterior leaflet prolapses, and anterior-directed if the posterior leaflet prolapses). Real-world imaging can show some variation due to how the Doppler beam is aligned, but central jet is the characteristic when both leaflets prolapse.

When the regurgitation comes through a central orifice, the jet travels straight into the middle of the left atrium. Bileaflet prolapse creates a regurgitant orifice that is effectively midline, so the MR jet is directed centrally.

In contrast, a single leaflet prolapse tends to push the jet toward the side opposite that leaflet (posterior-directed if the anterior leaflet prolapses, and anterior-directed if the posterior leaflet prolapses). Real-world imaging can show some variation due to how the Doppler beam is aligned, but central jet is the characteristic when both leaflets prolapse.