Mitral Stenosis, Regurgitation & Prolapse Q & A

The Doppler jet of mitral stenosis obtained from the apex is sometimes confused with?

Aortic Insufficiency (AI)

The mitral valve is composed of?

Chordae tendae, mitral annulus

Long standing severe mitral stenosis usually leads to?

Congestive heart failure

Which echocardiographic technique is best for the detection of mitral regurgitation?

Continuous wave

What are the findings associated with Mitral Stenosis?

Decreased E-F slope, thickened mitral valves & diastolic doming of the MV

Secondary findings of mitral stenosis

Dilated RA, dilated LA, left atrial thrombosis & A-Fib

What mitral conditions could be associated with mitral regurgitation?

Flail leaflet, calcification, MV rupture

An increase in the A wave of the mitral valve suggests?

Increase in diastolic pressure

Mitral regurgitation results in?

Increase in pre load

A doppler signal obtained from the apex of a patient with Mitral Stenosis would show

Increased in diastolic peak velocity, spectral broadening & decreased E-F slope regardless if obtained from the apex

The M Mode findings in mitral regurgitation are?

LV & LA dilation

What are the echo / Doppler findings associated with papillary muscle dysfunction?

Left atrial enlargement, mitral regurgitation, incomplete mitral closure

Why is the patient with MS often missing the A wave in M-mode?

MS causes A-fib & the A wave of the MV corresponds to the P wave on the EKG so if the P wave is absent, the A wave will be absent too.

What could be associated with mitral valve prolapse?

MV regurgitation

Peak mitral regurgitant velocity tells us?

Max instantaneous pressure difference of LV & LA

Clinically, prolapse of the mitral valve is associated with: (what type of murmur)

Mid systolic or late Click murmur syndrome

What is MAC?

Mitral Annular Calcification

The E - F slope of the mitral valve provides information about?

Mitral stenosis & left ventricular function

Doming of the anterior mitral leaflet is seen in?

Mitral stenosis AKA a floppy mitral valve

A 2D echo criteria that can be helpful in determining mitral regurgitation is?

Premature closer of the aortic valve

Estimation of the mitral valve area from Doppler is calculated by the?

Pressure half time

The E -F slope of the mitral valve corresponds to which event in the cardiac cycle (what phase) ?

Rapid diastolic filling

Left atrial dilation is associated with?

Significant MR, increased pulmonary pressure

M Mode findings with a flail mitral valve are?

Systolic flutter of MV, vegetation of the MV

A patient with Mitral Stenosis will usually have

a history of rheumatic fever, a dilated LA & a diastolic rumble on auscultation

dP/dT =

delta Pressure/ delta Time is a measurement of Mitral regurgitation from 1mm to 3mm

If you suspect severe MR you need to look at

the pulmonary veins

A patient with both mitral stenosis & aortic stenosis would have

A dilated LA & left ventricular hypertrophy; MS causes the LA to dilate & AS leads to LVH.

The color flow examination of the stenotic mitral valve would display?

A narrow jet, central blue, zone surrounding yellow & red hues

The criteria that defines mitral stenosis on M mode?

Anterior movement of the posterior leaflet

Premature mitral valve closure on M Mode is a sign of high left ventricular diastolic pressure in?

Aortic Insufficiency (AI)

The 2D echo view best for Doppler analysis of mitral regurgitation is ?

Apical 4

The mitral 2D view that is used in continuous wave Doppler imaging of mitral stenosis is the?

Apical 4

Midsystolic click and or late systolic murmurs are most characteristic of?

Mitral valve prolapse

A patient sent to the echo lab with a diagnosis of Marfan's syndrome. What are you most likely to see on echo?

Mitral valve prolapse & enlarged aorta

The posterior leaflet of the mitral valve appears to have a smaller excursion than the anterior leaflet because?

One is more posteriorly connected

Mitral stenosis results primarily from

Rheumatic Fever

Atrial Fibrillation is commonly associated with which Valvular disease?

Rheumatic mitral valve stenosis

What conditions could be associated with mitral regurgitation?

Ruptured chordae, calcification, flail leaflets

The 2D view that allows for calcification of the mitral valve orifice is the?

SAX of the mitral valve

The criteria most helpful in defining mitral stenosis is?

Thickened MV leaflets & left atrium enlargement

Term myxomatous degeneration used to describe a mitral valve prolapse denotes?

Thickening of the mitral valve leaflets