Q. How to Investigate mitral stenosis by Echocardiography?

Echocardiography is diagnostic in mitral stenosis. There is varying degrees of thickening and calcification of leaflets with subvalvular fusion. Commissural fusion results in typical fish mouth appearance of mitral orifice as seen in para sternal short axis view. The same is responsible for anterior motion of posterior leaflet in diastole. Excursion of leaflets and E-F slope on M mode are decreased. Anterior mitral leaflet has a typical hockey stick appearance. Left atrium is enlarged and it becomes a source of clots. Morphological features of mitral valve are of importance in assessing the suitability of mitral valve for balloon valvuloplasty. These features are given in the table. A valve score less than 8 predicts a favourable outcome with balloon valvuloplasty, while a score more than 8 does not preclude valvuloplasty.