Which combination defines moderate mitral stenosis by planimetry and mean gradient?

Which combination defines moderate mitral stenosis by planimetry and mean gradient?

• A. MVA >1.5 cm^2 and mean gradient <5 mmHg
• B. MVA 2.0 cm^2 and mean gradient 0 mmHg
• C. MVA 1.0-1.5 cm^2 and mean gradient 5-10 mmHg
• D. MVA <1.0 cm^2 and mean gradient >10 mmHg

Answer: (C)

In mitral stenosis, severity is judged by both the valve area and the pressure gradient across the valve. Planimetry gives the mitral valve area (MVA) directly by tracing the open orifice in diastole, while the mean gradient comes from Doppler measurements of the flow across the valve. Moderate stenosis is defined by mid-range values for both: an MVA between about 1.0 and 1.5 cm^2 and a mean transvalvular gradient between about 5 and 10 mmHg. This reflects a level of obstruction that is neither mild nor severe, but enough to produce a noticeable gradient and reduction in valve area. So the combination of MVA in the 1.0–1.5 cm^2 range with a mean gradient in the 5–10 mmHg range fits the moderate category. The other scenarios describe mild stenosis (larger area, lower or zero gradient) or severe stenosis (smaller area, high gradient).

In mitral stenosis, severity is judged by both the valve area and the pressure gradient across the valve. Planimetry gives the mitral valve area (MVA) directly by tracing the open orifice in diastole, while the mean gradient comes from Doppler measurements of the flow across the valve. Moderate stenosis is defined by mid-range values for both: an MVA between about 1.0 and 1.5 cm^2 and a mean transvalvular gradient between about 5 and 10 mmHg. This reflects a level of obstruction that is neither mild nor severe, but enough to produce a noticeable gradient and reduction in valve area.

So the combination of MVA in the 1.0–1.5 cm^2 range with a mean gradient in the 5–10 mmHg range fits the moderate category. The other scenarios describe mild stenosis (larger area, lower or zero gradient) or severe stenosis (smaller area, high gradient).