Mitral stenosis Diagnosis
Some tests use to diagnosis for Mitral stenosis include:
1. X-ray examination: the first change is that left heart obvious curvature of the left atrium, pulmonary trunk prominent widened pulmonary vein, right anterior oblique perspective barium can be seen expanding esophageal left atrial compression. Severe lesions, the left atrium and right ventricle increased significantly, after the front shows the right edge of the heart shadow was a double shadow of hilar shadow deepened smaller aortic arch. Left ventricular generally do not. After long-term pulmonary congestion hemosiderin deposition, under double-lung field may be scattered in the shadow of the point. Often occur in elderly patients with mitral valve calcification.
2. ECG: electrocardiogram may be normal in mild mitral stenosis. Changes characteristic is that P-wave peaks were widened and shaped, suggesting that increased left atrium. With pulmonary hypertension, the increase shows that the right ventricle, the right side axis. Often combined with advanced disease with atrial fibrillation.
3. Echocardiography: is the most common diagnosis for Mitral stenosis, to determine valve area and cross-valve pressure gradient to determine the extent of lesions, surgical methods as well as evaluating the decision of the efficacy of surgery are of great value. Two-dimensional echocardiography before and after mitral valve can be seen on leaf reflectance increased, thickening, activity rate decreased diastolic body forward before the leaf was bulging like a balloon, before and after the flap tip distance was significantly shorter leaves, orifice area reduced. M-mode ultrasonography can be seen the rate drop in diastolic filling, the normal two peaks disappeared, E slow post-peak decline curve, mitral anterior leaflet, diastolic posterior lobe in the former was subordinate to the movement with the leaf, the so-called change-like battlements . Expansion of the left atrium, right ventricular hypertrophy and right ventricular outflow tract widening. Doppler ultrasound showed a slow and decreasing blood flow through the mitral valve.
4. Inspection of radionuclides: radionuclide blood pool imaging showed expansion of the left atrium, and concentration imaging agent through time, left ventricular not. Pulmonary hypertension, the pulmonary trunk can be seen and the expansion of the right ventricle.
5. Right heart catheterization: right ventricle, pulmonary artery and pulmonary capillary pressure increased, pulmonary vascular resistance increases, reducing cardiac output. After atrial septal puncture can be directly measured left atrial and left atrial pressure, early diastolic mitral stenosis inter-valve pressure gradient normal, with the condition worsened, the pressure gradient increased.