Doppler evaluation of mitral stenosis is best described by which statement?

Doppler evaluation of mitral stenosis is best described by which statement?

• A. Best recorded in apicals; increased E and A velocities; increased PHT and decel time
• B. Best recorded in parasternal; decreased E and A velocities; decreased PHT
• C. Best recorded in apicals; decreased E velocity; increased decel time
• D. Best recorded in apicals; increased E velocity; decreased PHT

Answer: (A)

Mitral stenosis is best evaluated with Doppler sampling of the transmitral inflow from the apical view. The narrowed mitral valve creates a higher diastolic gradient, so the velocities across the valve rise, meaning both the early (E) and late (A) diastolic filling waves are increased. This increased gradient also lengthens the time it takes for pressure to equalize across the valve, so the pressure half-time (PHT) becomes longer and the E-wave deceleration time is prolonged. Put together, increased E and A velocities with increased PHT and extended deceleration time, sampled apically, describe Doppler findings typical of mitral stenosis.

Mitral stenosis is best evaluated with Doppler sampling of the transmitral inflow from the apical view. The narrowed mitral valve creates a higher diastolic gradient, so the velocities across the valve rise, meaning both the early (E) and late (A) diastolic filling waves are increased. This increased gradient also lengthens the time it takes for pressure to equalize across the valve, so the pressure half-time (PHT) becomes longer and the E-wave deceleration time is prolonged. Put together, increased E and A velocities with increased PHT and extended deceleration time, sampled apically, describe Doppler findings typical of mitral stenosis.