In this parasternal long axis TTE clip, the mitral valve does not open normally. The anterior leaflet buckles in a \hockey stick\ fashion. The posterior leaflet does not open but is tethered to the anterior and pulls forward as the anterior tries to open. This was confirmed by M-mode doppler. Also noted on M-mode was the absence of an A wave causing a second opening of the mitral valve. This is because the early filling is not adequate to empty to the atrium before atrial systole.