Fig. 9.1 Top: Calcified semilunar cusps in aortic stenosis. Bottom: Pressure overload causes concentric left ventricular hypertrophy.

Fig. 9.2 The parasternal short-axis view is particularly well-suited for visualizing decreased opening motion although separation does not permit estimation of the degree of stenosis.

Fig. 9.7 Moderately calcified valves in medium-grade aortic stenosis. The moderately elevated pressure gradient has not caused hypertrophy of the left ventricle.

Fig. 9.8 CW Doppler mode displays a moderate rise in flow velocity up to approximately 3 m/s. Computer-assisted conversion yields a maximum gradient of 36 mmHg.

Fig. 9.9 Marked calcification of the aortic valve. There is concentric left ventricular hypertrophy.

Fig. 9.10 CW Doppler demonstrating a rise in flow velocity up to 5 m/s, corresponding to a maximum gradient of 100 mmHg. Patience and time are necessary to obtain a usable CW analysis of transaortic flow.

Fig. 9.11 Top: Calcified mitral valve in mitral stenosis. Bottom: Dilatation of the left atrium and right heart as a result of pressure overload.

Fig. 9.12 In the parasternal short-axis view, the remaining mitral valve orifice area can be seen directly and planimetered using computer analysis. Under good visualization, this value can be used for quantification.

Fig. 9.15 Top: Moderate calcification of the valve leaflets and atrial dilatation. Bottom: The minimal increase in transmitral inflow velocity causes a circumscribed color change.

Fig. 9.16 Top: CW Doppler shows a rapid decline in transmitral inflow. Bottom: Computer-assisted quantification yields a functional valve orifice area of > 2 cm².

Fig. 9.17 Marked calcification of the mitral valves as well as a considerably dilated left atrium can be seen. Increased inflow velocity across the stenotic valve appears like a candle flame in the image.

Fig. 9.18 Top: CW Doppler imaging shows a slow decrease in transmitral inflow velocity. Bottom: Analysis of the slope velocity yields a valve orifice area of 1.0 cm².