Mitral Valve Prolapse & Regurgitant Jet

Cardiac Phase

Systole

Valve Pathology

Posterior leaflet prolapse 40%

Annular diameter 32 mm

Heart rate 70 bpm

Live Hemodynamics

Coaptation gap

0.0 mm

EROA (PISA-style)

0.00 cm²

Regurgitant fraction

0 %

How it works

Mitral valve prolapse (MVP) is billowing of one or both leaflets ≥2 mm above the annular plane during systole — most often the P2 scallop of the posterior leaflet, which this model animates. When the billowing free edge no longer meets the anterior leaflet along a stable coaptation line, a real orifice is left open through peak systole and left‑ventricular pressure drives blood backward into the left atrium: mitral regurgitation (MR).

Clinically the severity of MR is graded with the PISA (proximal isovelocity surface area) method: as flow converges toward a small orifice it forms nested hemispheric shells of equal velocity, so the flow rate through any shell of radius r equals the flow rate through the orifice itself:

Q = 2πr² · V_alias
EROA = Q / V_max
R_vol = EROA × VTI_MR   (regurgitant volume per beat)

where V_alias is the Nyquist (aliasing) velocity read off the color Doppler shell, V_max is the peak continuous‑wave jet velocity, and VTI_MR is the jet's velocity‑time integral. This simulator can't image a Doppler shell, so it takes a simplified but physically consistent shortcut: it derives an orifice geometry directly from the coaptation gap opened by the leaflet billow and annular size, then applies the same Q = EROA × V_jet relationship (with a typical LV→LA systolic jet velocity of ≈ 5 m/s) to estimate regurgitant volume and, against an assumed 70 mL forward stroke volume, regurgitant fraction.

Posterior leaflet prolapse — how far the free edge billows above the annular plane and pulls away from the anterior leaflet at peak systole.
Annular diameter — a dilated annulus (normal ≈ 30 mm) stretches the leaflets thinner across the same span, widening any gap for a given amount of prolapse — the mechanism behind secondary/functional MR.
Heart rate — sets the cardiac cycle speed; systole occupies roughly the first third of each beat, when the jet is possible at all.
Rupture chordae — models a torn chorda tendinea: the leaflet segment loses its restraint and flails freely (an unrestrained, higher‑amplitude, oscillating billow), producing the most severe acute MR.

Left atrium Left ventricle Regurgitant jet

⚠ Couldn't load the 3D engineThree.js failed to load from the CDN. Check your connection and reload.