Mitral Valve Disease in Echo
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listening to sound in the body
- Severe orthopnea
- L and/or R Heart Failure
What is Mitral Regurgitation
backwards flow of blood through the MV during systole (most common)
Is MR the same as Mitral Insufficiency
- No. But commonly referred to as.
- Regurg results from Insufficiency.
How long does MR last?
Intermittent; acute; chronic
Ways to treat MR:
- Prophylactic antibiotics
- Catheter balloon valvuloplasty
- Mitral Valve Replacement
What is the most common treatment for MR
Ways to determine MV Area (MVA):
- Pressure Half time
- Continuity Equation
Planimetetry of MV?
- trace valve orifice (opening) in PSAX.
- Must find smallest on-axis opening
Pressure Half Time (PHT) of MV?
Valve Area calculated by dividing measured PHT into 220 (constant).
How many times must PHT be measured in patients showing indications of A-Fib?
Multiple because it gives a rough estimate of what their actual pressure values are during erratic streak.
Can PHT be measured accurately after a balloon valvuloplasty?
No. Because the recent balloon inserted in their valve would show faulty values of what their body was actually producing.
Where is PHT measured?
- Spectral Wave Doppler of MV leaflet tips during dystole.
- the E-F descending slope, is then measured.
What is PHT used for?
Calculation mitral valve Area
What is the PISA method used for?
Calculating MV Area
What does PISA stand for?
Why is PISA rarely used?
Not easily reproducible by sonographers
Principle behind PISA
stipulates that unobstructed flow convergence equates to concentric acceleration. Shows acceleration at different points in time
How to measure PISA
- 1. A4C - Zoom MV
- 2. Apply Color doppler
- 3. Shift of zero baseline upward (Nyquist Limit)
- 4. Save to Cine loop
- 5. Freeze best frame to measure radius of MR in LA
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