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Prepared by : Dr.Hatem Bakarman supervised by: Dr.Hanan Al-Baker

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Introduction. Echo indications. Scores of MS. Assessment severity of MS.

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23years woman referred for possible BMV for Rheumatic MS. Calculate a)mitral valve score. b)Mean PHT. C)MVA. DT=583mesc

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Normal mitral valve Two leaflets. MVA = 4-6 cm 2.

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RHD. Mitral annular calcification. Congenital. RA SLE.

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increase LAP MVA MGP Pulmonary edema+ PHT Pulmonary venous pressure RHF Pressure on right heart.

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DX of MS & assessment of severity Re-evaluation in patient known of Ms TTE Assessment of LA thrombus Evaluate severity of MS befor PMBV Evaluation of MS when TTE is suboptimal TEE Class I Revaluate in patient who known MS & stable clinical finding. ClassIIa TEE is not indication routine evaluation of MS when TTE is satisfactory. ClassIII ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease Circulation 2006 Mild MS :every 3-5 year moderateMS:every 1-3 year Severe MS:every 1 year

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Assessment diminish mobility & doming of Ant leaflet. Assessment morphology of MV (scoring). MVA (planimetry). LA enlargement. & thrombus. RV enlargement. (HOCKEY STICK ).

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1.PAP. 2.MVA. 3.Pressure gradient.

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SEVEREMODERATEMILDSEVERITY >50mmhg30-50mmhg105-10