Mitral flow is assessed by placing the Doppler cursor just distal to the mitral valve in apical four chamber meeting. Two diastolic waves, E and A are seen in normal mitral Doppler. The E wave is early diastolic and A wave occurs during atrial systole. Hence A wave is absent in atrial fibrillation. Normally E wave is taller than A wave. A wave becomes prominent in diastolic dysfunction of the left ventricle. This leads to E/A reversal.
Mitral flow pattern by Doppler. Normally E is taller than A wave
Mitral Doppler in diastolic dysfunction showing E / A reversal
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