Overview
The disease menus support multiple selections. For example, you can combine a valve lesion with a cardiomyopathy or pulmonary vascular disease. Valve choices are organized by Mitral, Aortic, Tricuspid and Pulmonic valves.
The same regurgitant lesion cannot be both its acute and chronic version at once; selecting one replaces the incompatible counterpart. Acute structural emergencies also activate the shock phenotype.
Combined states are modeled interactions, not simple arithmetic addition of each preset pressure. Read the final pressure/flow result. Mixed conditions use one representative disease-related ECG finding at a time.
Aortic stenosis raises the LV pressure driving mitral regurgitation, while MR reduces forward aortic flow and can lower the observed stenotic gradient. Mixed MS/MR and TS/TR account for recirculating inflow; right-sided obstruction/regurgitation also share reserve. These bounded teaching interactions depend on severity and are not calibrated patient predictions.
Aortic stenosis with HOCM retains separate LV–LVOT and LVOT–aortic gradients. Mixed mitral disease retains both inflow obstruction and regurgitant atrial loading. Mean wedge and LVEDP remain different measurements.
Automated combination checks test flow conservation, pressure relationships and representative waveforms. They do not clinically validate every combination of diseases, severity, rhythm, ventilation and treatment; extreme mixtures remain illustrative.