Standard Views of the Mitral Valve

Mitral Valve OutlineAnatomy of the Mitral ValveStandard Views of the Mitral Valve2D Echocardiography of Mitral StenosisDoppler Assessment of Mitral StenosisClassification of Mitral Regurgitation2D Echocardiography of Mitral RegurgitationPulse Wave Doppler of Mitral RegurgitationColor Flow Doppler of Mitral RegurgitationSummaryCME and Self Assessment Exams

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 SCA/ASE guidelines.

Views of the Mitral Valve ASE/SCA
	ME 5CV not a Standard view
	ME 4CV A3/P1	ME PCV P3/P2/P1	bTG SAX
	ME MCV P3/A2/P1	ME 2CV P3/A1	TG 2CV
	ME ACV A3/A2/A1	ME LAX A2/P2


Probe Position	Base of Heart Beam Angle	View

Probe Position/Views

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 The probe can be either slightly ante flexed or withdrawn to obtain an anteriorly directed beam which shows a 5 chamber view.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.