Which imaging issue is listed as a false-positive for MVP?

• A. left ventricular hypertrophy
• B. off axis imaging
• C. mild pericardial effusion
• D. pulmonary edema

Answer: (B)

Imaging artifacts can masquerade as mitral valve prolapse on echocardiography. Off-axis imaging changes the angle at which the mitral valve is visualized, which can create apparent systolic displacement of the leaflets into the left atrium even when the valve is normal. This foreshortening or misalignment makes the leaflets look like they prolapse, producing a false-positive finding. To avoid this, obtain standard views from multiple angles and ensure the imaging plane is properly aligned with the mitral valve, confirming with additional views or modalities if needed.

Other options reflect actual heart conditions or imaging effects that are not typical sources of a false-positive MVP. Left ventricular hypertrophy involves thickened ventricular walls rather than the valve’s appearance; mild pericardial effusion and pulmonary edema alter the cardiac silhouette or hemodynamics but do not reliably mimic MVP on echo.