Standard Views of the Mitral Valve - Part 1
Mitral Valve OutlineAnatomy of the Mitral ValveStandard Views of the Mitral Valve - Part 1Standard Views of the Mitral Valve - Part 2Standard Views of the Mitral Valve - Part 3Standard Views of the Mitral Valve - Part 43D Views of the Mitral ValveEtiology of Mitral Stenosis2D Echocardiography of Mitral StenosisDoppler Assessment of Mitral Stenosis - Part 1Doppler Assessment of Mitral Stenosis - Part 2Etiology and Classification of Mitral Regurgitation2D Echocardiography of Mitral Regurgitation - Part 12D Echocardiography of Mitral Regurgitation - Part 22D Echocardiography of Mitral Regurgitation - Part 32D Echocardiography of Mitral Regurgitation - Part 43D Evaluation of Mitral RegurgitationDoppler Evaluation of Mitral RegurgitationColor Flow Doppler of Mitral Regurgitation - Part 1Color Flow Doppler of Mitral Regurgitation - Part 2Color Flow Doppler of Mitral Regurgitation - Part 3Color Flow Doppler of Mitral Regurgitation - Part 4Color Flow Doppler of Mitral Regurgitation - Part 5Color Flow Doppler of Mitral Regurgitation - Part 6Color Flow Doppler of Mitral Regurgitation - Part 7SummaryCME and Self Assessment Exams
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| Standard Views of the Mitral Valve | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| The standard views of the mitral valve complex are the listed below. From each view, components of the mitral valve complex can be identified and assessed to indicate the mechanism of mitral valve dysfunction. All of the standard views, if possible, should be included in the evaluation of the mitral valve. Listed below are the standard views based upon the SAC/ASE guidelines, views from the Foster article, and views from the Lambert article. | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Probe Position/Views | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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All of the above views can be incorporated into an echo exam of the mitral valve.
The probe is then advanced to the standard 4 chamber view.
The multiplane plane may have to be slightly rotated up to 20 degrees to obtain an optimal view of the 4 chamber view.
The probe can be either slightly anteflexed or withdrawn to obtain an anteriorly directed beam which shows a 5 chamber view. The probe is slightly retroflexed or advanced from the standard 4 chamber view to obtain a posteriorly directed 4 chamber view. Returning to the standard 4 chamber view, the multiplane plane is rotated to 30 - 60 degrees to obtain the mitral commissural view. The probe is rotated to the right to obtain the anterior commissural view and rotated to the left for the posterior commissural view. Returning to the mitral commissural view, the multiplane plane is rotated to 90-110 degrees to obtain the standard 2 chamber view. Rotating the multiplane plane to 130 degrees obtains the aortic valve long axis view. The short axis view of the mitral valve is obtained by returning the multiplane plane to 0 degrees, advancing the probe to the basal transgastric acoustic window, and slightly flexing the probe. The transgastric 2 chamber view is obtained by advancing the probe to the mid transgastric acoustic window and rotating the multiplane angle to 90 degrees. From the systematic examination of the mitral valve, the mechanism of mitral regurgitation and/or stenosis is usually evident. |
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| Midesophageal 5 Chamber View (ME 5CV) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| The 5 chamber view is not a standard SCA/ASE view. The 5 chamber view is obtained by withdrawing or slightly ante flexing the probe from the 4 chamber view. The 5 chamber view cuts through the aortic valve and the anterior aspect of the mitral valve. The A1/P1 scallops are that are visualized according to Foster. The A1/P1 or A2/P2 scallops are visualized according to Lambert. The midesophageal 5 chamber view contains the left atrium, left ventricular outflow tract, mitral valve annulus, anterior mitral valve leaflet, posterior mitral valve leaflet, chordae, anterolateral papillary muscle and the lateral myocardial wall. | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Midesophageal 4 Chamber View (ME 4CV) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| The 4 chamber view cuts through the middle of the mitral valve and the middle or posterior portion of the tricuspid valve (posterior and septal leaflets). The A3/P1 scallops are present in this view according to the ASE/SCA guidelines. The midesophageal 4 chamber view contains the lateral and septal walls of the myocardium and the anterolateral papillary muscle. | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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Lambert has the 4 chamber view showing the A2/3 and P2/3 scallops. Withdrawing the probe from the 4 chamber view shows the 5 chamber view. |
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