Fig. 1

a. Transthoracic two-dimensional echocardiography showing abnormal chordae tendineae with reticular structures (arrow) and slightly thickened mitral leaflets in systole. b. Parasternal long-axis view showing pear-shaped mitral orifice during diastole (arrow) with chords attached to the posteromedial papillary muscle, with the leaflets forming the larger base of the pear and the chordae tendinae the apex. c. A single large papillary muscle in short-axis format was detected. A small muscular ridge or trabecula was present at the location of anterolateral papillary muscle without any chordal attachment. d. Reticular chordae tendineae with scattered holes among them was confirmed in 3D transesophageal echocardiography