Mitral Stenosis

Mitral Stenosis Severity

Assess mitral stenosis severity anchored on mitral valve area (MVA). Mean gradient provides hemodynamic context only — it does not independently classify severity. Includes PHT method accuracy warnings, AF and low-flow confounders, and etiology modifier flags.

ACC/AHA VHD 2020

Input

Enter available values — partial input is supported.

Mitral valve area (MVA) — primary severity anchor

MVA is the primary determinant of MS severity. Planimetry (2D or 3D) and invasive pressure gradient (IVPG) are the most reliable methods. Pressure half-time (PHT) is commonly used but is less reliable in the presence of specific conditions — see pitfall flags below.

Severe ≤ 1.5 cm² (very severe < 1.0 cm²)

MVA measurement method

Qualitative MS grade

Qualitative grade is supportive context only. When MVA is available, MVA drives the primary grade.

Mean gradient — hemodynamic context

Mean gradient is rate- and flow-dependent and reflects hemodynamic significance, not anatomic severity alone. It does not independently classify MS severity. A gradient of ≥ 10 mmHg is considered hemodynamically significant in this context.

Hemodynamically significant ≥ 10 mmHg — context only

Severity assessment

Enter MVA (with measurement method) or a qualitative MS grade to receive a severity assessment. Mean gradient and symptom data provide context only.

Learn the echo reasoning pathway

Review how valve severity, LV function, filling pressures, and intraoperative TEE findings connect in perioperative echo assessment.

Open Echo Education