When measuring the mitral orifice size in mitral stenosis, what should be done?

In the assessment of mitral stenosis, measuring the mitral orifice size is crucial for understanding the severity of the condition. The correct approach is to measure the opening from the leaflet tips. This method provides an accurate representation of the functional area of the mitral valve when it is open, reflecting the degree of restriction caused by stenosis.

Measuring from the leaflet tips allows for a direct assessment of the effective orifice area during diastole, which is essential in evaluating how well blood can flow from the left atrium into the left ventricle. This measurement is important for clinical decision-making, such as determining the need for intervention or surgery.

While other options may offer some insights, they do not provide the same level of precision in evaluating the severity of mitral stenosis. For example, estimating based on left atrial size can give a general idea of the impact of the stenosis but does not directly correlate with the functional orifice area. Each of the alternatives lacks the specificity that directly measuring the opening at the leaflet tips provides, which is integral to the accurate assessment of mitral valve function in the context of stenosis.