Table 2.
Stages of mitral stenosis
| Characteristic | Stage | ||||
|---|---|---|---|---|---|
| A | B | C | D | ||
| Definition | At risk | Progressive | Asymptomatic severe | Symptomatic severe | |
| Severity | Normal to insignificant | Mild | Moderate | Severe | |
| Echocardiography morphology | |||||
| Leaflet | Mildly fibrotic or sclerotic, mild doming | Partial fibrothickening, sclerocalcified, doming | Severe fibrothickening, sclerocalcified, doming | ||
| Commissure | No fusion | Mild to moderate fusion | Severe fusion | ||
| Annulus | Mild calcification | Mild to moderate calcification | Severe calcification | ||
| Area (cm2) | - | > 2.5 | 1.6–2.5 | ≤ 1.5 (very severe, ≤ 1.0) | |
| MDPG (mmHg) | - | < 3 | 3–5 | ≥ 5 (very severe, ≥ 10) | |
| PHT (msec) | - | < 100 | 100–149 | ≥ 150 | |
| PASP (mmHg) | Normal | Normal | Normal at rest | Normal at rest or > 50 | > 50 |
| LA size | Normal | Normal or ↑ | ↑ | ↑ | |
| Symptom | None | None | None | DOE, EI | |
MDPG Mean diastolic pressure gradient, PHT Pressure half-time, PASP Pulmonary artery systolic pressure, LA Left atrium, DOE Dyspnea on exertion, EI exercise intolerance