MDM of mitral stenosis is a “ mid diastolic misnomer ”

Nearly a century ago, Carl Wiggers helped us understand the dynamics of cardiac cycle with a historical diagram depicting systole and diastole. We know diastole has 4 phases. They are  IVRT(nil)  early rapid filling,(70%) diastasis,(0-5%) atrial contraction(25%) (Percentage filling within the brackets) What is mid diastole? The easiest way to define mid diastole is to divide diastole into three parts with reference to time and call the mid-third as mid-diastole. (.5 seconds/ divided by 3). But, Physiologically we can’t do that. Even hemodynamically there is no distinct mid diastole as diastole is divided into 4 phases as described earlier. When there are 4 parts how can we slice out mid diastole without an overlap?  So, what shall we do? Technically which is the best period to be referred to as mid diastole? Maybe diastasis. In this period either little or no flow occurs. HR heavily influence the duration of diastasis. Cardiologists especially during auscultation created the concept of calling anything happening after mitral valve opening as mid diastole. ie after IVRT which equals* A2-MV opening interval (In the true sense,  it must be the early diastole that can begin with mitral valve opening for physiologists, but for cardiologists, it begins with aortic valve closure because we can hear only closing sounds) What happens in mitral stenosis?  Any significant obstruction of the mitral valve, the gradient builds up immediately after the mitral ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Auscultation Cardiology - Clinical Clinical cardiology Mitral stenosis Uncategorized cardiologist vs physiologist diastole diastasis murmur diastolic time intervals edm in mitral stenosis ivrt vs at os interval mdm in mitral stenosis Source Type: blogs