Mitral stenosis stages: Difference between revisions
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|'''Stage'''||'''Definition'''||'''Valve Anatomy'''||'''Valve Hemodynamics'''||'''Hemodynamic Consequences'''||'''Symptoms''' | |'''Stage'''||'''Definition'''||'''Valve Anatomy'''||'''Valve Hemodynamics'''||'''Hemodynamic Consequences'''||'''Symptoms''' | ||
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|'''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 | ||
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|'''B'''||Progressive [[MS]]|| Commissural fusion and diastolic doming of [[mitral valve]]<br>[[Mitral valve]] area (MVA) > 1.5 cm<sup>2</sup> (planimetered)||Increased transmitral flow velocities<br>MVA > 1.5 cm<sup>2</sup> <br>Pressure half time during diastole < 150 ms||Mild to moderate left atrial enlargement<br>Normal pulmonary pressure at rest ||None | |'''B'''||Progressive [[MS]]|| ❑ Commissural fusion and diastolic doming of [[mitral valve]]<br>❑ [[Mitral valve]] area (MVA) > 1.5 cm<sup>2</sup> (planimetered)||❑ Increased transmitral flow velocities<br>❑ MVA > 1.5 cm<sup>2</sup> <br>❑ Pressure half time during diastole < 150 ms||❑ Mild to moderate left atrial enlargement<br>❑ Normal pulmonary pressure at rest ||None | ||
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|'''C'''||Asymptomatic severe [[MS]]||❑ Commissural fusion and diastolic doming of [[mitral valve]]<br> ❑ MVA ≤ 1.5 cm<sup>2</sup><br>❑ MVA ≤ 1 cm<sup>2</sup> in very severe [[MS]]|| ❑ 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||None | |||
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|'''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 | |||
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Revision as of 00:39, 10 March 2014
| Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Stages
| 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 |