Mitral Stenosis
Evaluate MS severity anchored on mitral valve area. Mean gradient reflects hemodynamic burden — it does not independently classify severity. PHT method accuracy, AF, low-flow state, and etiology all shape the interpretation.
Assess MS severity
Classify MS severity using ACC/AHA 2020 integrated criteria. MVA-anchored classification with PHT method accuracy warnings, AF and low-flow confounders, and etiology modifier flags.
MS Intervention Navigator
Evaluate intervention pathways for significant MS based on severity, symptom status, morphology, and clinical context.
Learn the concepts
Why MVA anchors the grade, what makes PHT unreliable, and how discordant hemodynamics should be interpreted.
Clinical context
MVA is the primary severity anchor — not mean gradient
MS severity is classified by mitral valve area. Mean gradient reflects the hemodynamic burden at a given flow and heart rate — not the anatomic severity of the valve lesion. A low gradient does not exclude severe MS if MVA is ≤ 1.5 cm².
PHT is commonly used but context-dependent
Pressure half-time estimates MVA from transmitral pressure decay. Its accuracy is reduced by coexistent AR, post-valvotomy state, tachycardia, LV diastolic dysfunction, and coexistent MR. When these are present, planimetry or 3D echocardiography provides more reliable MVA.
Etiology shapes intervention complexity — not the severity grade
Rheumatic, MAC-related, prosthetic, and congenital MS all produce MVA obstruction, but intervention approach, eligibility, and complexity differ substantially. The severity grade is MVA-anchored regardless of etiology; modifier flags highlight where standard pathways do not apply.