There are a number of measurements that need to be taken when assessing mitral stenosis:
1. Diastolic pressure gradient - This is not a reliable method of estimating the severity of MS. Mean gradient is a better measure than peak gradient. The pressure gradient is dependent on a number of factors such as heart rate.
2. Planimetry - is a good way to estimate the severity of MS. It is measured in parasternal short axis view in mid-diastole, with appropriate gain settings.
3. Pressure half-time - This is the time taken for the diastolic pressure gradient to drop to half from its peak. Though a good indicator in the presence of normal LV function, it is less reliable in diastolic dysfunction, which is often seen in MS secondary to degenerative disease. MV area = 220 / PHT
4. Continuity equation - though useful, it's using should be avoided in atrial fibrillation.
5. PISA - useful, but depends on operator experience.
It is also important to estimate left atrial size and systemic pulmonary artery pressure. Also, keep in mind that multiple measurements will need taking in atrial fibrillation.
Keep the following measurements in mind (from EAE/ASE recommendations)
1. Diastolic pressure gradient - This is not a reliable method of estimating the severity of MS. Mean gradient is a better measure than peak gradient. The pressure gradient is dependent on a number of factors such as heart rate.
2. Planimetry - is a good way to estimate the severity of MS. It is measured in parasternal short axis view in mid-diastole, with appropriate gain settings.
3. Pressure half-time - This is the time taken for the diastolic pressure gradient to drop to half from its peak. Though a good indicator in the presence of normal LV function, it is less reliable in diastolic dysfunction, which is often seen in MS secondary to degenerative disease. MV area = 220 / PHT
4. Continuity equation - though useful, it's using should be avoided in atrial fibrillation.
5. PISA - useful, but depends on operator experience.
It is also important to estimate left atrial size and systemic pulmonary artery pressure. Also, keep in mind that multiple measurements will need taking in atrial fibrillation.
Keep the following measurements in mind (from EAE/ASE recommendations)
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