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| {{SI}}
| | #Redirect [[Mitral stenosis treatment overview]] |
| {{CMG}}
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| '''Associate Editor-In-Chief:''' {{CZ}}
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| ==Treatment==
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| The treatment options for mitral stenosis include medical management, [[mitral valve replacement|surgical replacement]] of the valve, and [[percutaneous]] balloon [[valvuloplasty]].
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| Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to [[New York Heart Association Functional Classification|NYHA functional class]] II symptoms to the development of atrial fibrillation to the development of NYHA functional class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient's condition deteriorates. | |
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| ==Pharmacotherapy==
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| * In asymptomatic patients, use endocarditis prophylaxis and chronic anticoagulation for intermittent or chronic atrial fibrillation, systemic embolism and marked LA enlargement (>55mm).
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| * In symptomatic patients, control heartrate and Maintain NSR (normal sinus rhythm) (digoxin, antiarrhythmic agents) and B-blockers. Use diuretics for control of pulmonary edema. The decision of whether to proceed with vavluloplasty or surgical commissurotomy depends on the severity of symptoms and/or severe (>50mm Hg) PHTN. Relative indications would be for Class II, III symptoms, episodic pulmonary edema, prevention of thromboembolism, or moderate (45-50mm Hg) PHTN. The decision of whether valvuloplasty is superior to surgery depends on age (<60 favors valvuloplasty), and Cath/ECHO findings (e.g. LVEDP, degree of mobility, thickening and calcification). The average end result with both strategies is about 2 cm2. Moderate or greater MR (mitral regurgitation) and LA thrombus are contraindications to valvuloplasty.
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| ==References==
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| {{Reflist}}
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| [[Category:Valvular heart disease]]
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| [[Category:Cardiology]]
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