Mitral Stenosis

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Mitral Stenosis

1. The normal mitral valve area is:

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1.5 - 2 cm

2 - 3 cm

3 - 4 cm

4 - 5 cm

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2. Worldwide, the most common cause of mitral stenosis is:

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Degenerative calcification

Rheumatic heart disease

Congenital mitral stenosis

Atrial myxoma causing 'pseudo mitral stenosis'

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3. Which is TRUE regarding mitral valve morphology?

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In rheumatic MS, commissural fusion results in a funnel shaped mitral valve

In calcific MS, leaflet tip fusion results in a funnel shaped mitral valve

Rheumatic valve disease is characterized by early annular calcification

Calcific MS is characterized by the 'hockey-stick' appearance of the anterior mitral valve leaflet

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4. Which of the following conditions will make pressure half time unreliable when estimating mitral valve area?

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Left ventricular diastolic dysfunction

Aortic regurgitation

Atrial fibrillation

Tachycardia

Prosthetic mitral valve

All of the above

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5. The continuity equation is based on the physical law of:

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Conservation of mass

Conservation of energy

The Bernoulli principle

Conservation of matter

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6. Which of the following DOES NOT preclude the use of the continuity equation to derive the mitral valve area?

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atrial fibrillation

mitral regurgitation

aortic regurgitation

diastolic dysfunction

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7. According to the 2009 ASE/EAE guidelines, which of the following should be performed in all patients with suspected mitral stenosis?

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Determination of MVA by planimetry

Determination of MVA by P1/2t

Measurement of mean transvalvular gradient

All of the above should be performed according to guidelines

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8. Which of the following is not consistent with severe MS?

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Mean pressure gradient > 10mmHg

Peak pressure gradient > 10mmHg

Mitral valve area < 1.0cm2

Pressure half time >220

PA pressure >50mmHg

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9. Which of the following views allows for the best assessment of the subvalvular apparatus?

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ME4C

ME2C

TG basal 'fishmouth' view

TG two chamber

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10. Which of the following is not a component of the Wilkin's score used to predict the success rate of percutaneous mitral valvotomy?

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Leaflet mobility

Calcification of the valvular apparatus

Peak transmitral pressure gradient

Leaflet thickening

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