Mitral stenosis stages: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 6: | Line 6: | ||
{|Class="wikitable" | {|Class="wikitable" | ||
|- | |- | ||
|''' | |'''STAGE'''||'''DEFINITION'''||'''VALVE ANATOMY'''||'''VALVE HEMODYNAMICS'''||'''HEMODYNAMIC CONSEQUENCES'''||'''SYMPTOMS''' | ||
|- | |- | ||
|'''A'''||At risk of [[MS]]||❑ Mild diastolic doming of mitral valve leaflets||❑ Normal transmitral velocity||None||None | |'''A'''||At risk of [[MS]]||❑ Mild diastolic doming of mitral valve leaflets||❑ Normal transmitral velocity||None||None | ||
| Line 16: | Line 16: | ||
|'''D'''||Symptomatic severe [[MS]]||❑ Commissural fusion and diastolic doming of [[mitral valve]]<br> ❑ MVA ≤ 1.5 cm<sup>2</sup>||❑ MVA ≤ 1.5 cm<sup>2</sup><br>❑ MVA ≤ 1 cm<sup>2</sup> in very severe [[MS]]<br>❑ Diastolic pressure half time ≥ 150 ms<br> ❑ Diastolic pressure half time ≥ 220 ms with very severe [[MS]]||❑ Severe left atrial enlargement<br>❑ PASP > 30 mm Hg||❑ [[Dyspnea]] on exertion<br>❑ Decreased exercise tolerance | |'''D'''||Symptomatic severe [[MS]]||❑ Commissural fusion and diastolic doming of [[mitral valve]]<br> ❑ MVA ≤ 1.5 cm<sup>2</sup>||❑ MVA ≤ 1.5 cm<sup>2</sup><br>❑ MVA ≤ 1 cm<sup>2</sup> in very severe [[MS]]<br>❑ Diastolic pressure half time ≥ 150 ms<br> ❑ Diastolic pressure half time ≥ 220 ms with very severe [[MS]]||❑ Severe left atrial enlargement<br>❑ PASP > 30 mm Hg||❑ [[Dyspnea]] on exertion<br>❑ Decreased exercise tolerance | ||
|} | |} | ||
<span style="font-size:85%">'''MS:''' Mitral stenosis; '''MVA:'''Mitral valve area; '''PASP:''' Pulmonary artery systolic pressure;</span> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 00:50, 10 March 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Stages of Mitral Stenosis
Shown below is a table depicting 4 stages of mitral stenosis, adapted from 2014 AHA/ACC guidelines for management of valvular heart diseases.[1]
| STAGE | DEFINITION | VALVE ANATOMY | VALVE HEMODYNAMICS | HEMODYNAMIC CONSEQUENCES | SYMPTOMS |
| A | At risk of MS | ❑ Mild diastolic doming of mitral valve leaflets | ❑ Normal transmitral velocity | None | None |
| B | Progressive MS | ❑ Commissural fusion and diastolic doming of mitral valve ❑ Mitral valve area (MVA) > 1.5 cm2 (planimetered) |
❑ Increased transmitral flow velocities ❑ MVA > 1.5 cm2 ❑ Pressure half time during diastole < 150 ms |
❑ Mild to moderate left atrial enlargement ❑ Normal pulmonary pressure at rest |
None |
| C | Asymptomatic severe MS | ❑ Commissural fusion and diastolic doming of mitral valve ❑ MVA ≤ 1.5 cm2 ❑ MVA ≤ 1 cm2 in very severe MS |
❑ MVA ≤ 1.5 cm2 ❑ MVA ≤ 1 cm2 in very severe MS ❑ Diastolic pressure half time ≥ 150 ms ❑ Diastolic pressure half time ≥ 220 ms with very severe MS |
❑ Severe left atrial enlargement ❑ PASP > 30 mm Hg |
None |
| D | Symptomatic severe MS | ❑ Commissural fusion and diastolic doming of mitral valve ❑ MVA ≤ 1.5 cm2 |
❑ MVA ≤ 1.5 cm2 ❑ MVA ≤ 1 cm2 in very severe MS ❑ Diastolic pressure half time ≥ 150 ms ❑ Diastolic pressure half time ≥ 220 ms with very severe MS |
❑ Severe left atrial enlargement ❑ PASP > 30 mm Hg |
❑ Dyspnea on exertion ❑ Decreased exercise tolerance |
MS: Mitral stenosis; MVA:Mitral valve area; PASP: Pulmonary artery systolic pressure;
References
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0000000000000029. PMID 24589852.