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==Mitral Stenosis== | ==Mitral Stenosis== | ||
<span style="font-size:85%">'''Abbreviations:''' '''AF''': [[atrial fibrillation]]; '''MS:''' [[mitral stenosis]]; '''MR:''' [[mitral regurgitation]]; MVA: ; MVR: ;PCWP: ;PMBC: ;T<sub>1/2</sub>: | |||
{{Familytree/start}} | {{Familytree/start}} | ||
{{Family tree | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | A01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Determine the severity of mitral stenosis (MS)</div>}} | {{Family tree | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | A01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Determine the severity of mitral stenosis (MS)</div>}} | ||
{{Family tree | | | | | | | | |,|-|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|.| | | | }} | {{Family tree | | | | | | | | |,|-|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|.| | | | }} | ||
{{Family tree | | | | | | | | B01 | | | | | | | | B02 | | | | | | | | | | | B03 | | | B01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Very severe MS <br> MVA ≤1 cm2 <br> T1/2 ≥220 ms </div>| B02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Severe MS <br> MVA ≤1.5 cm2 <br> | {{Family tree | | | | | | | | B01 | | | | | | | | B02 | | | | | | | | | | | B03 | | | B01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Very severe MS <br> MVA ≤1 cm2 <br> T1/2 ≥220 ms </div>| B02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Severe MS <br> MVA ≤1.5 cm2 <br> T<sub>1/2</sub> ≥150 ms </div>| B03= <div style="float: left; text-align: left; width: 8em; padding:1em;">Progressive MS <br> MVA >1.5 cm2 <br> T<sub>1/2</sub> <150 ms </div>}} | ||
{{Family tree | | | | | | | | |!| | | | | | | | | |!| | | | | | | | | | | | |!| | }} | {{Family tree | | | | | | | | |!| | | | | | | | | |!| | | | | | | | | | | | |!| | }} | ||
{{Family tree | | | | | | | | B04 | | | | | | | | B05 | | | | | | | | | | | B06 | B04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic? </div>| B05= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic?</div>| B06=<div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic? </div>}} | {{Family tree | | | | | | | | B04 | | | | | | | | B05 | | | | | | | | | | | B06 | B04= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic? </div>| B05= <div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic?</div>| B06=<div style="float: left; text-align: left; width: 8em; padding:1em;">Is the patient symptomatic? </div>}} | ||
Revision as of 12:01, 22 July 2014
Mitral Stenosis
Abbreviations: AF: atrial fibrillation; MS: mitral stenosis; MR: mitral regurgitation; MVA: ; MVR: ;PCWP: ;PMBC: ;T1/2:
Determine the severity of mitral stenosis (MS) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Very severe MS MVA ≤1 cm2 T1/2 ≥220 ms | Severe MS MVA ≤1.5 cm2 T1/2 ≥150 ms | Progressive MS MVA >1.5 cm2 T1/2 <150 ms | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Is the patient symptomatic? | Is the patient symptomatic? | Is the patient symptomatic? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No (Stage C) | Yes (Stage D) | No (Stage C) | Yes With no other cause for the symptoms | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Does the patient have: ❑ Favorable valve morphology AND ❑ No left appendage clot AND ❑ No or mild MR | Does the patient have: ❑ Favorable valve morphology AND ❑ No left appendage clot AND ❑ No or mild MR | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Is there a new onset of AF? | Order an exercise stress test | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Yes | Yes | No | Yes | No | Is PCWP> 25 mm Hg? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Does the patient have: ❑ NYHA class III-IV symptoms AND ❑ High surgical risk | Does the patient have: ❑ Favorable valve morphology AND ❑ No left appendage clot AND ❑ No or mild MR | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No | Yes | Yes | No | Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Periodic monitoring | PMBC (Class IIa) | PMBC (Class I) | MVR (Class I) | PMBC (Class IIb) | Periodic monitoring | PMBC (Class IIb) | Periodic monitoring | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||