Congenital anomaly. Calcinosis (idiopathic) of the left atrioventricular orifice. Rheumatism. Lyutembash syndrome
Mode B: 1. dome-shaped diastolic bulging of the fibro-modified or calcined anterior cusp of the mitral valve into the LV cavity (“sailing” of the leaf); 2. the increase or dilatation of the cavity of the LP, the appearance of blood clots in it; 3. The image of the mitral orifice in the shape of a “fish mouth” in a section along the short axis.
M-mode: 1. the movement of the anterior cusp into the diastole acquires a “P” shaped form (atrial wave A disappears); 2. unidirectional movement of the rear sash relative to the front; 3. a decrease in the EF velocity of the anterior cusp (speed of the early diastolic cover) and the degree of divergence of the cusps in the diastole (less than 20 mm).
Doppler: 1. an increase in the diastolic pressure gradient between LP and LV (from 12 to 40 mm Hg); 2. slowing down the rate of diastolic filling (flattening of the spectrogram); 3. pronounced flow turbulence. By the speed of tilt of the anterior leaf in diastole EF (M-mode), the half-time of the flow curve (Doppler mode), and also planimetrically along the short axis (B-mode), you can determine the area of the mitral orifice (Smo) and estimate the degree of mitral stenosis. The following degrees of stenosis are distinguished: critical stenosis (Smо less than 1.1 cm 2 ); pronounced stenosis (Smo = 1.2 – 1.7 cm 2 ); moderate stenosis (Sm = 1.8 – 2.2 cm 2 ) and minimal stenosis (S m exceeds 2.3 – 2.4 cm 2 ). It must be emphasized that these authors may differ among themselves by different authors.
From apical position On long axis from parasternal access
The nature of the movement of the valves MK Calculation of pressure gradient and hole area
Measurement of the MO area along the short axis of echoCG in mitral stenosis (explained in the text).