My report says MV annulus is out of range. What does that mean?

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It means that the annulus of one of the valves on left side, called mitral valve, is reduced in diameter. So, there is an obstruction to the flow of blood from the low-pressure chamber to the high-pressure chamber, that is, from the left atrium to the left ventricle, which can give rise to symptoms like palpitation or shortness of breath. If it is reduced progressively, the condition is called as mitral stenosis. You will need to get an echocardiogram done at regular intervals and follow up with the cardiologist accordingly.