Table 1: Grading of mitral valve characteristics according to Wilkins score.

GradeMobilityThickeningCalcificationSubvalvular thickening

1Highly mobile valve with only 1 leaflet tips restrictedLeaflets near normal in thickness (4-5 mm)A single area of increased echo brightnessA single area of increased echo brightness

2Leaflet midportions and base portions have normal mobilityMidleaflets normal, considerable thickening of margins (5–8 mm)Scattered areas of brightness confined to leaflet marginsScattered areas of brightness confined to leaflet margins

3Valve continues to move forward in diastole, mainly from the baseThickening extending through the entire leaflet (5–8 mm)Brightness extending into the midportion of the leafletsThickening extending to the distal third of the chords

4No or minimal forward movement of the leaflets in diastoleConsiderable thickening of all leaflet tissue (>8–10 mm)Extensive brightness throughout much of the leaflet tissueExtensive thickening and shortening