Last week we walked through a case study demonstration, using the ASE’s chronic mitral regurgitation (MR) algorithm. This week, we have another case study to present– let’s see how you quantify the severity of MR!

Chronic MR Algorithm Chart:

Patient History:

60 year old female presented for her routine echocardiogram. BSA is 1.91 m² and blood pressure (BP) is 110/68. The patient has the following history:

• Congestive Heart Failure
• Controlled Hypertension
• End-stage Renal Disease
• Former Smoker

Parasternal Long Axis (PLAX):

Vena Contracta:

Apical 4 (AP4):

Mitral Valve Inflow:

Pulmonary Vein Flow:

Color Jet Area:

PISA Radius:

MR CW Doppler Jet:

Measurements:

• End-Diastolic Volume (EDV) Indexed: 104 mL/m²
• Ejection Fraction (EF): 23%
• LA Volume Indexed: 49 mL/m²
• Vena Contracta Width: 0.5 cm
• MV Inflow E-Wave: 0.9 m/s
• PISA Radius (Flow Convergence): 0.7 cm
• Aliasing Velocity: 39 cm/sec
• MR VTI: 5.95 m/s & 226 cm

What is the MR severity?!

Summary

We hope you enjoyed working through this case study! Keep an eye out for future case studies and blog series covering the ASE guidelines!

Andrea Fields MHA, RDCS

Stay Connected: LinkedIn, Facebook, Twitter, Instagram

References: 

Zoghbi, W. A., MD, FASE, & Adams, D., RCS, RDCS, FASE. (2017). Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation. JASE, 30, 4th ser., 1-69. Retrieved June 12, 2017.