Conditions Valve lesions

Mitral stenosis

Obstruction to LV filling. The transmitral gradient depends on flow and on the time available for filling, so tachycardia raises LA pressure sharply while the LV itself is under-filled and its EDP normal.

Experiment: Normal adult at rest · unchanged from its starting state

Key measurements

Transmitral mean diastolic gradient

— mmHg

baseline not set

— mmHg

baseline not set

— mL

baseline not set

— L/min

baseline not set

Inspect beats and technical detailsbeat selection, transient versus settled, timings

Position within the beat0.000 s

Early beats after a change are transient: the circulation is still re-balancing. A beat is called settled when three consecutive windows agree within the tolerance. Playback speed only moves the cursor over the finished simulation; it never changes the heart rate.

Compare scenariosbaseline, snapshots, axes, export

Baseline

No baseline is set.

Comparison snapshots

Keep up to three snapshots of states you want to compare with the baseline and the current state.

How comparisons are drawn

Side-by-side loops instead of an overlay Identical axes for every loop (turn off and each plot rescales to its own data)

Pressure–volume loop options

Show the ESPVR and EDPVR reference lines Shade stroke work Show the arterial elastance (Ea) line Show the right heart instead of the left

Export

Choose a version

Differences from normal: mitral effective orifice 4.5 → 1.0 cm²; LA V0 10 → 60 mL and stiffness 0.04 → 0.02 (dilated LA); blood volume 5000 → 5300. Expected: transmitral diastolic gradient that rises with heart rate, raised LA/wedge pressure with a normal LVEDP, reduced LV filling.

What to look for

Diastolic gradient between LA () and LV; wedge ≫
Gradient and rise with heart rate
Loss of atrial contraction (AF) removes the late-diastolic push

Try it

Set values directly

Mitral valve areacm²

How this works

Effective orifice area of the mitral valve.

Changes: valves.mv.eoa

Compare scenariosloads two scenarios side by side

MS at 70 vs 110 bpm

Shorter diastole forces the same flow through the orifice in less time: higher gradient and wedge.

Common misconception. A raised in MS does not mean LV failure: is normal and the problem is upstream of the ventricle.

Apply it

The first haemodynamic goal in MS with rapid AF is to:

Lengthen diastole (rate control) to lower the gradient and LA pressureGive an inotropeGive fluid

← Aortic regurgitation Mitral regurgitation →

Sources & model detailsreview status, testing, limitations

Sources

Content review

Teaching text and answer keys: Proposed. None of the 2 source claims behind it has been expert reviewed. Where a question has more than one defensible answer, more than one is accepted.

Simulation testing

Finding Hemo closed-loop lumped-parameter model: Quantitatively tested. Software, conservation and qualitative pattern tests pass. Not expert reviewed; normal ranges and phenotype parameter sets are proposed teaching values.
Scenario “Normal adult at rest” is checked for: closed-system volume conservation (<0.1% over 100 beats); timestep sensitivity (<1% change in core stable measurements at dt/2); seeded repeatability; resting pressures, volumes and flows within stated textbook ranges; directional response to fluid bolus and afterload increase.

Passing these tests means the equations are solved correctly and behave as stated. It does not mean the teaching statements, parameter values or answer keys have been expert reviewed.

Limitations that matter here

Quantitative compartment model: fixed orifice; LA dilation as parameters.
Reflexes are off: no autonomic compensation follows a change (the optional baroreflex is not enabled).
Constant intrathoracic pressure -3 mmHg (respiratory swing disabled).

Technical details

Model: fh-closed-loop 0.4.0
App / content version: 0.5.0 / 0.5.0
Scenario id: normal-adult
Solver: rk4, dt 0.2 ms
Condition id: mitral-stenosis