A 6 year old girl with apical systolic murmur underwent transthoracic two dimensional colour Doppler echocardiography. An isolated mild mitral regurgitation was noticed. The mitral regurgitant jet emanated through the anterior mitral valve. The left ventricle was not dilated with normal shortening fraction. Real time three dimensional echocardiography (Sonos 7500, Philips) was performed using the matrix probe (2–4 MHz). A full volume was acquired from an apical window with ECG monitoring. En face view of the mitral valve was obtained immediately. The asymptomatic patient was followed up without surgical indication.

Three dimensional en face view of the mitral valve. The valve is viewed from below. The anterior mitral valve is divided into two equivalent leaflets by a cleft (C). The anterior (A) and posterior (P) commissures as well as the papillary muscles underneath are clearly seen delimitating the posterior mitral valve.