Mitral stenosis stages
| 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 |