What is the typical 2DE appearance of rheumatic mitral stenosis?

The mitral leaflets and chordae tendineae are thickened and calcified.
The leaflets are tethered at the tips, so that the most severely restricted motion is found at the point of coaptation.
Tethering results in the classic hockey stick appearance of the anterior mitral leaflet in diastole and is responsible for doming of the valve.
The posterior leaflet is often totally immobile.
Although the hockey stick appearance of the anterior leaflet and the fixed posterior leaflet are specific for rheumatic mitral stenosis, restricted leaflet motion and doming of the valve are found in all forms of mitral stenosis.