Mitral valve stenosis gradient across the mitral valve increases, the amount of time necessary to fill the left ventricle with blood increases. Eventually, the left ventricle requires the atrial kick to fill with blood. As the heart rate increases, the amount of time that the ventricle is in diastole and can fill up with blood (called the diastolic filling period) decreases. When the heart rate goes above a certain point, the diastolic filling period is insufficient to fill the ventricle with blood and pressure builds up in the left atrium, leading to pulmonary congestion. When the mitral valve area goes less than 1
Mitral insufficiency broad, notched P waves in several or many leads with a prominent late negative component to the P wave in lead V, and may be seen in MI, but also in mitral stenosis, and, potentially, any cause of overload of the left atrium. Thus, "P-sinistrocardiale" may be a more appropriate term. The degree of severity of MR can be quantified by the regurgitant fraction, which is the percentage of the left ventricular stroke volume that regurgitates into the left atrium. where V and V are, respectively, the volumes of blood that flow forward through the mitral valve and aortic valve