Imaging in mitral stenosis

Mitral stenosis remains clinically relevant in developing countries where rheumatic heart disease is the predominant culprit. In the western world, mitral annular and valvular calcification is an increasingly recognized cause, particularly in an aging population. Echocardiography plays a primary role in imaging mitral stenosis with a growing role for cardiac computed tomography and magnetic resonance imaging. In this review, we aim to revisit mitral stenosis assessment and quantification using multimodality imaging.

There is an increasing role for advanced cardiac imaging especially in the era of transcatheter mitral valve intervention. Also, when echocardiography is suboptimal or discordant with symptoms, computed tomography can provide anatomical data, whereas magnetic resonance imaging can provide anatomical along with hemodynamic data.

Diagnosis of mitral stenosis is crucial as it carries an increased morbidity and mortality risk. Echocardiography is the cornerstone imaging modality with alternative, complementary advanced imaging considered when images are suboptimal.