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Revision as of 11:39, 22 July 2014

Mitral Stenosis

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?

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

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

Yes

No

Yes

No

@@ Line 10: / Line 10: @@
 {{Family tree | | | C01 | | | | | | | C02 | | | | | | | | | | | C03 | | | | C04 | | | C01= No (Stage C)| C02= Yes (Stage D)| C03= No (Stage C)| C04= Yes <br> With no other cause for the symptoms}}
 {{Family tree | | | |!| | | | | | | | |!| | | | | | | | | | | | |!| | | | | |!| | | | }}
-{{Family tree | | | D01 | | | | | | | D02 | | | | | | | | | | | D03 | | | | D04 | | | D01= Assess if: <br> Valve morphology is favorable <br> No left appendage clot <br> No or mild MR| D02= | D03= | D04= }}
+{{Family tree | | | D01 | | | | | | | D02 | | | | | | | | | | | D03 | | | | D04 | | | D01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> AND <br>❑ No left appendage clot <br> <br> AND <br>❑ No or mild MR </div>| D02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> <br> AND <br>❑ No left appendage clot <br><br> AND <br> ❑ No or mild MR </div>| D03= Is there a new onset of AF?| D04= Order an exercise stress test}}
 {{Family tree | |,|-|^|-|.| | | |,|-|-|^|-|-|.| | | | | | | |,|-|^|-|.| | | |!| | | | }}
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+{{Family tree | E01 | | E02 | | E03 | | | | E04 | | | | | | E05 | | E06 | | E07 | | | E01= No| E02= Yes| E03= Yes| E04= No| E05= Yes| E06= No| E07= Is PCWP> 25 mm Hg?}}
 {{Family tree | |!| | | |!| | | |!| | | | | |!| | | | | | | | | | | |!| |,|-|^|-|.| | }}
-{{Family tree | |!| | | |!| | | |!| | | | | F01 | | | | | | F02 | | |!| F03 | | F04 | F01= | F02= | F03= | F04= }}
+{{Family tree | |!| | | |!| | | |!| | | | | F01 | | | | | | F02 | | |!| F03 | | F04 | F01= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ NYHA class III-IV symptoms <br> AND <br> ❑ High surgical risk </div>| F02= <div style="float: left; text-align: left; width: 8em; padding:1em;">Does the patient have: <br> ❑ Favorable valve morphology <br> <br> AND <br>❑ No left appendage clot <br> <br> AND <br>❑ No or mild MR </div>| F03= Yes| F04= No}}
 {{Family tree | |!| | | |!| | | |!| | | |,|-|^|-|.| | | |,|-|^|-|.| |!| |!| | | |!| | }}
-{{Family tree | |!| | | |!| | | |!| | | G01 | | G02 | | G03 | | G04 |!| |!| | | |!| | G01= | G02= | G03= | G04= }}
+{{Family tree | |!| | | |!| | | |!| | | G01 | | G02 | | G03 | | G04 |!| |!| | | |!| | G01= No| G02= Yes| G03= Yes| G04= No}}
 {{Family tree | |!| | | |!| | | |!| | | |!| | | | |!| |!| | | | |!| |!| |!| | | |!| | }}
 {{Family tree | H01 | | H02 | | H03 | | H04 | | | | H05 | | | | | H06 | | H07 | | H08 | H01= | H02= | H03= | H04= | H05= | H06= | H07= | H08= }}
 {{Familytree/end}}

Sandbox Rim: Difference between revisions

Revision as of 11:39, 22 July 2014

Mitral Stenosis

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