Diagnostic studies-mitral-stenosis

• ECG: LAE (“P mitrale”), ± AF, ± RVH
• CXR: dilated LA (flat L heart border, R double density, displaced L mainstem bronchus)
• Echo: estimate pressure gradient (∇), RVSP, valve area, valve echo score (0–16, based on leaflet mobility & thick, subvalvular thick., Ca++); exer. TTE (to assess ∆ RVSP and ∇) if sx & severity of MS at rest discrepant; TEE to assess for LA thrombus before PMBC
• Cardiac cath: ∇, calculated MVA; LA tall a wave & blunted y descent; ↑ PA pressures Grading-of-Mitral-Stenosis