Apical four chamber view of mitral stenosis

The apical four chamber view from a two dimensional echocardiogram of a patient with mitral stenosis shows left (LA) and right atrial (RA) dilation, biatrial thrombi (arrows), calcification of the mitral valve (MV) commissures, and chordal forshortening and thickening. Although the thrombi are well seen, it is unusual to see atrial thrombi without transesophageal echocardiography.