In MVPS mitral valve HPE shows,

Ans. is 'c' i.e. Myxomatous degeneration Mitral valve prolapse or myxomatous degeneration of the valve is the most common form of valvular heart disease in the industrialized world.In this valvular abnormality one or both mitral leaflets are "floppy" and prolapse or balloon back into the left atrium during systole.The myxomatous degeneration of the valve is caused due to underlying developmental defect of connective tissue.The characteristic anatomical change in myxomatous degeneration is intercarpal ballooning (hooding) of the mitral leaflets or its portions.This occurs because of the attenuation of the fibrous layer of the valve on which the structural integrity of the valve depends.Histological examination also reveals marked thickening of the spongiosa layer with deposition of mucoid (myxomatous) material.The secondary changes associated with this condition reflects the stresses and injury which occurs after the billowing of the leaflets:-Fibrous thickening of the valve leaflets, particularly where they rub against each other.Linear fibrous thickening of the left ventricular endocardial surface where abnormally long cord snaps against it.Thickening of the mural endocardium of the left ventricle or atrium as a consequence of friction induced injury induced by prolapsing leaflets.Thrombi on the atrial surface of the leaflets particularly in the recesses behind the ballooned cusps and on the atrial walls these thrombs contact.Focal calcification at the base of posterior mitral leaflet.