This is a still frame of a 2-dimensional parasternal long axis view that clearly shows thickened mitral valve leaflets that are typical of rheumatic disease.
The aortic root, aortic valve, and left ventricle are well seen, as is the enlarged left atrium.
In the real-time study that follows, note the restricted motion of the mitral valve leaflets.
This is a still frame of the parasternal short axis view showing the mitral valve. In the frame that follows, note that the orifice of the mitral valve can be outlined and its area estimated by planimetry.
The patient’s estimated valve orifice size is 0.6 cm2, while the normal size is 4.5 cm2.
This is a still frame of a color flow doppler image from the apical four chamber view. the right atrium, right ventricle, enlarged left atrium, and normal left ventricle are clearly shown.
The mosaic color pattern in the left ventricle indicates that flow from the left atrium is markedly turbulent, a finding typical of significant mitral stenosis.
In the real-time study that follows, note that mitral valve motion is restricted.
This is a still frame of a continuous wave doppler study that demonstrates significant mitral stenosis. The reduced diastolic slope reflects delayed left ventricular filling due to mitral valve obstruction. The increased peak and mean velocities of the mitral valve diastolic jet are directly related to the severity of the stenosis. The mitral valve area obtained in this study correlates well with that obtained by planimetry.
In the real-time study that follows, note the characteristic sound that is generated by this procedure in a patient with mitral stenosis.
The severity of mitral stenosis can be classified as mild, moderate, or severe using the mean gradient, pulmonary artery systolic pressure, and mitral valve area.
During the complete transthoracic echo-doppler study in this patient, additional findings were demonstrated, including severe tricuspid regurgitation associated with pulmonary hypertension, no significant mitral regurgitation, and no evidence of left atrial thrombi. The latter was confirmed by a transesophageal echocardiogram.