Four-dimensional flow cardiovascular magnetic resonance for the assessment of mitral stenosis

James Wardley,Pankaj Garg,Alisdair Ryding,Andrew Swift,Massimo Mapelli,Deborah Cosmi,Anna Giulia Pavon

doi:10.1093/ehjcr/ytab465

Abstract

Four-dimensional flow cardiovascular magnetic resonance for the assessment of mitral stenosis

Highlights

A 52-year-old lady presented with breathlessness with no physical stigmata of heart failure
On transoesophageal echocardiography (TOE), the mean pressure gradient (PG) was 7 mmHg and the mitral regurgitation (MR) was severe with a PISA of 0.1–1.02 cm (Figure 1D–F)
Coronary angiography did not demonstrate any coronary disease and the invasive haemodynamic assessment was in keeping with the TOE with 6 mmHg mean PG (Figure 1M and N); the mitral valve (MV) area was 2.1 cm2 by the Gorlin method

Summary

Introduction

A 52-year-old lady presented with breathlessness with no physical stigmata of heart failure. Four-dimensional flow cardiovascular magnetic resonance for the assessment of mitral stenosis Transthoracic echocardiography demonstrated a rheumatic-looking mitral valve (MV) with a mean pressure gradient (PG) of 12 mmHg, a dilated left atrium (32 cm2), and moderate mitral regurgitation (MR) (Figure 1A–C) (Video 1).

Results

Conclusion