MITRAL
STENOSIS
Classic M-mode findings for Mitral Stenosis:
v Thickened
mitral valve leaflets
v Decreased
mitral valve E-F slope
v Anterior
motion of the posterior mitral valve leaflet
Two dimensional echo finding for rheumatic MV
stenosis:
v Hockey-stick
appearance of the anterior mitral valve leaflet
v Increase
left Atrial dimension
v Thickened
MV leaflets and subvalvular apparatus
Other Two dimensional echo/Doppler finding include:
v D-shaped
left ventricle
v Left
Atrial thrombus
v Abnormal
interventricular septal wall motion
v Increase
right heart dimension
v Increased
TV regurgitation jet velocity
v Increased E velocity
v Increased Pressure half-time
v Turbulent flow
MVA: Severe
stenosis = less than 1.0 cm2
Moderate = 1.1 to 1.5
cm2
Mild stenosis = 1.6 to 2.5 cm2
Normal MVA = 4 to 6 cm2
MVA (cm2) = 220/PHT (msec)
The abnormal range for PHT in patient with MV
stenosis is 90 to 400 msec. MV stenosis is considered severe when PHT is 220
msec or longer.
PHT (msec) = Deceleration Time x 0.29
Mean Pressure gradient (tracing CW Doppler spectral
wave form)
v Severe
stenosis = more than 10 mmHg
v Moderate = 4 to 10 mmHg
v Mild
stenosis = less than 4 mmHg
SEVERE MITRAL VALVE STENOSIS:
Ø MEAN
PRESSURE GRADIENT MORE THAN 10 mmHg
Ø MITRAL
VALVE AREA LESSN THAN 1.0 cm2
Ø PRESSURE
HALF TIME MORE THAN 220 msec
