mitral stenosis echo criteria - a really stupid question

[BelaMedicine]

Apologies if this is really basic but I don't understand this.

A normal mitral valve area is 4-6 cm2. In the ASE guidelines where they have a table differentiating the criteria for mild, moderate and severe. It says valve area >1.5 is mild and 1-1.5 is moderate. Gradient for mild is listed as <5.

So what about when you have a valve that appears calcified and not moving totally normally but valve area is lets say 2 or 3. When you go to gradient criteria it says <5 is mild. How do you differentiate or draw the line between mild and normal?? If valve area is less than 4 (which is normal) and gradient is anything less than 5 then by definition this becomes mild. Is that correct??

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[IMreshopeful]

Apologies if this is really basic but I don't understand this.

A normal mitral valve area is 4-6 cm2. In the ASE guidelines where they have a table differentiating the criteria for mild, moderate and severe. It says valve area >1.5 is mild and 1-1.5 is moderate. Gradient for mild is listed as <5.

So what about when you have a valve that appears calcified and not moving totally normally but valve area is lets say 2 or 3. When you go to gradient criteria it says <5 is mild. How do you differentiate or draw the line between mild and normal?? If valve area is less than 4 (which is normal) and gradient is anything less than 5 then by definition this becomes mild. Is that correct??

If any doubt get a TEE
Valve planimetry by 3D probably most accurate IMO
Honestly it really only matters if it’s a severe MS - if it’s mild who cares. Doesn’t even affect need for anticoagulation