Echo-Doppler study in children with rheumatic mitral stenosis [prediction of severity]

ABSTRACT

The diagnosis of mitral stenosis is well settled with the advantage of echocardiogram. However, assessment of the severity of the disease is still unimproved. The purpose of this study is to evaluate the specific role of echo-Doppler. ECG, and X-ray findings in predicting the severity of rheumatic mitral stenosis. Ten children with isolated rheumatic mitral stenosis, proved clinically and by investigations were studied with echo-Doppler. ECG, and X-ray. The mitral valve areas determined by planimetery correlated closely with Doppler derived areas. [r = 0.981]. Severe mitral stenosis was defined by a valve area <1 cm2. Two-dimensional echocardiographic analysis of the pliability, thickening and doming of anterior mitral leaflet was valuable in assessing the severity of mitral stenois. Absence of pericardial effusion and calcification of mitral valve was recorded in all our patients. Also, correlation between mitral valve areas and m-mode findings [left atrium/aortic ratio, end-diastolic dimensions, and shortening fraction] was good as the X-ray findings [heart volume]. In contrast ECG findings [width of P wave and R/S in V1] correlated poorly with the severity of mitral stenosis. Therefore, the most useful predictor of severity of mitral stenosis is echo-Doppler study and X-ray with ECG are considered as complementary methods: