Echocardiography Normal Vs Mitral Valve Stenosis | B-mode, M-Mode, Color & Spectral Doppler Findings

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Published Apr 26, 2026

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Echocardiography Normal Vs Mitral Valve Stenosis | B-mode, M-Mode, Color & Spectral Doppler Findings

*Cases
0:00 - B-Mode
4:05 - Color Doppler
6:53 - M-Mode
11:26 - Spectral Doppler

B-Mode:
- Hockey-Stick Appearance: Anterior leaflet often shows “doming” appearance in diastole.
- Thickened leaflets
- Mitral Valve Area: Mild mitral stenosis: Greater than 1.5 cm², Moderate: 1.0–1.5 cm², Severe: Less than 1.0 cm².
- Thickened leaflets, appearing hyperechoic
- Leaflets may appear fused
- Narrowed mitral valve orifice with a characteristic “fish-mouth” appearance on short-axis imaging.

Color Doppler
- Turbulent diastolic flow across the mitral valve with a mosaic color pattern (mixture of blue, red, and aliasing colors) rather than smooth laminar inflow.
- Candle Flame Sign: Narrow, high-velocity, and turbulent, jet of blood flows from the left atrium into the left ventricle during diastole, shaped like a burning candle flame.

M-Mode:
- Reduced or flattened E–F slope of the anterior mitral leaflet due to slow diastolic closure
- Decreased excursion of the anterior leaflet
- Paradoxical anterior motion of the posterior mitral leaflet (both leaflets move in the same direction during diastole because of commissural fusion).

Spectral Doppler:

Mild Mitral Stenosis
- Jet Velocity: ~1.5–2.0 m/s
- Mitral valve area reduction: Greater than 1.5 cm²
- Mean transmitral pressure gradient: Less than 5 mmHg
- Pulmonary artery pressure: Less than 30 mmHg

Moderate Mitral Stenosis
- Jet Velocity: ~2.0–2.5 m/s
- Mitral valve area: 1.0–1.5 cm²
- Mean transmitral pressure gradient: 5-10 mmHg
- Pulmonary artery pressure: 30-50 mmHg

Severe Mitral Stenosis
Jet Velocity: Greater than 2.5 m/s
Mitral valve area reduction: Less than 1.0 cm²
Mean transmitral pressure gradient: Greater than 10 mmHg
Pulmonary artery pressure: Greater than 50 mmHg