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This video clip transesophageal apical four-chamber view showing severe mitral regurgitation by color Doppler flow imaging (arrow). Arrowhead shows a kink in the middle of the anterior leaflet mimicking a “seagull.” This “seagull” sign results from tethering produced by a strut chord and is considered indicative of ischemic origin of cardiomyopathy. (LA: Left atrium; LV: Left ventricle; RV: Right ventricle).
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