Mitral Stenosis

2D Features of MS

Leaflet doming & thickening

Spectral Doppler Features of Severe MS

Gradual slope

Using Peak Velocity for MS

Only use to assess PHT and diastolic function

Do not use to calculate peak pressure gradient

Mean Pressure Gradient for Severe MS

> 10 mmHg

Pressure Half Time for MS

Independent of MR

Inversely proportional to valve area

The greater the PHT...

The more severe the MS

Planimetry

2D measurement that calculates area by tracing open leaflets in PSAX

Must be at leaflet tips

MVA for Mild MS

2.5-1.5 cm^2

MVA for Severe MS

< 1 cm^2

Continuity Equation for MVA

Calculates valve area using LVOT CSA & VTI, and MV VTI

Limitations of the Continuity Equation for MVA

Not valid if significant AI or MR are present

PISA for MS

Measure flow convergence radius

Measure MV peak velocity

Pulmonary A Pressure with Mild MS

< 30 mmHg

Pulmonary A Pressure with Severe MS

> 50 mmHg

Pressure Changes with MS

Increased LA pressure

Decreased LV pressure