In which view is PISA typically measured for MR assessment?

In which view is PISA typically measured for MR assessment?

• A. AP4/3 (4 preferred)
• B. Parasternal long axis
• C. Subcostal
• D. Apical 2-chamber

Answer: (A)

PISA measurement for mitral regurgitation relies on visualizing the hemispherical flow convergence around the regurgitant orifice. The apical four-chamber view is the standard window because it best aligns with the mitral valve orifice and the regurgitant jet, giving a clear, symmetric convergence region and reliable radius measurement at the aliasing velocity. From that radius you can calculate the flow rate through the orifice and derive the effective regurgitant orifice area and regurgitant volume. Other views can be used if needed, but they don’t provide the same consistent geometry as the apical four-chamber view, which is why it’s preferred (with apical three-chamber as an alternative).

PISA measurement for mitral regurgitation relies on visualizing the hemispherical flow convergence around the regurgitant orifice. The apical four-chamber view is the standard window because it best aligns with the mitral valve orifice and the regurgitant jet, giving a clear, symmetric convergence region and reliable radius measurement at the aliasing velocity. From that radius you can calculate the flow rate through the orifice and derive the effective regurgitant orifice area and regurgitant volume. Other views can be used if needed, but they don’t provide the same consistent geometry as the apical four-chamber view, which is why it’s preferred (with apical three-chamber as an alternative).