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Abnormal valve evaluation

Mild
Moderate
Severe
Mitral Regurgitation
LA size
Normal
Variable
Enlarged
LV size
Normal
Variable
Enlarged
Jet Area
<4 cm2
4–8 cm2
>8 cm2
Jet v/s LVOT area
>40%
Vena Contracta
<0.3
0.3–0.69
>0.7
Mitral flow (PW)
A dominant
Variable
Restrictive
Mitral flow (CW)
Faint
Dense
Regurgitant vol.
<30 ml/beat
30–59
>60
Reg. fraction (%)
<30
30–49
>50
ROA (cm²)
<0.20
0.20–0.39
>0.40
Mitral Stenosis
LA size
Normal
>60mm
Echo contrast
Usually absent
May be present
Present
Area
1.5–2.5 cm2
1.5–1.0 cm2
Up to 0.9 cm2
PISA formation
Absent
Usually +
Always +
Mean gradient
<2–6 mmHg
6–12 mmHg
>12 mmHg
PHT
<150 ms
150–220 ms
>220 ms
Deceleration time
<517
517–759
>759
Tricuspid Regurgitation
RA/RV/IVC size
Normal
Variable
Dilated
Valve structure
Normal
Variable
Flail/poor coaptation
TR Jet area
<5 cm2
5–10 cm2
>10 cm2
Hepatic vein flow
Syst. dominance
Systolic blunting
Systolic reversal
TV doppler CW
Soft parabolic
Dense variable
Dense triangular
Vena contracta
Not defined
<0.7 cm
>0.7 cm
PISA radius
<0.5 cm
0.6–0.9 cm
>0.9 cm
Tricuspid Stenosis
RA size
Normal
Dilated
RV size
Normal
Variable
Dilated
Jet density CW
Faint
Dense
Dense
Jet Dec. CW
Steep
Variable
Delayed
CW jet velocity
<1 m/sec
1–2.5 m/sec
>2.5 m/sec
Peak gradient
<4 mmHg
4–25 mmHg
>25 mmHg
Mean gradient
<2 mmHg
2–7 mmHg
>7 mmHg
Aortic Regurgitation
LV size
Normal
Variable
Large
Diast. flow reversal
Brief, early diastole
Variable
Holodiastolic reversal
CW doppler spectral
Faint
Variable
Dense
CW doppler spectral
Faint
Variable
Dense
PHT
>550
500–300
<300
Vena contact
<0.3 cm
0.3–0.6 cm
>0.6 cm
Jet width/LVOT
<25–45%
45–65%
>65%
Jet CSA/LVOT CSA
<5%
5–59%
>60%
Regurgitant Vol
<30 ml
30–59 ml
>60 ml
Regurg. Vol (Max.)
<30
30–59
>60
Regurgitant fraction
<30%
30–55%
>55%
Reg. Orifice Area (ROA)
<0.10
0.10–0.29
>0.30
Deceleration time
<2.0 m/sec
2.0–3.5 m/sec
>3.5 m/sec
Aortic Stenosis
Aortic cusp separation
>20 mm
10–20 mm
<10 mm
Valve area planimetry
1.0–2.5 cm²
0.7–1.0 cm²
<0.7–1.0 cm²
Peak velocity
2–3 m/s
3–4 m/s
>4 m/s
Mean gradient
5–25 mmHg
25–50 mmHg
>50 mmHg
Continuity eq.
1.5–2 cm²
1.0–1.5 cm²
<1.0 cm²
Dimensionless Index
<0.25
Others
MPI
0.40–0.60
0.60–1.00
>1.00
dP/dT (mmHg/sec)
>1200
1000–1200
<1000
Pul. Hypertension
30–40 mmHg
40–70 mmHg
>70 mmHg