Mitral stenosis general approach to mitral stenosis

Mitral Stenosis Microchapters
Home
Patient Information
Overview
Pathophysiology
Causes
Differentiating Mitral Stenosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Stages
History and Symptoms
Physical Examination
Electrocardiogram
Chest X Ray
Echocardiography
Cardiac MRI
Cardiac Catheterization
Treatment
Overview
Medical Therapy
Percutaneous Mitral Balloon Commissurotomy (PMBC)
Surgery
Follow Up
Prevention
Case Studies
Case #1
Mitral stenosis general approach to mitral stenosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Mitral stenosis general approach to mitral stenosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA onMitral stenosis general approach to mitral stenosis
CDC on Mitral stenosis general approach to mitral stenosis
Mitral stenosis general approach to mitral stenosis in the news
Blogs on Mitral stenosis general approach to mitral stenosis
Directions to Hospitals Treating Mitral Stenosis
Risk calculators and risk factors for Mitral stenosis general approach to mitral stenosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Overview

Mitral stenosis is a valvular disease characterized by a narrowing in the heart valve between the two left chambers of the heart (left atrium and left ventricle).

Pathophysiology

• Commisural fusion is the hallmark anatomic finding in mitral stenosis.
• The narrowing in the mitral valve causes build up of pressures in the left atrium, and eventually in the pulmonary bed.
• The build up of pressures in the pulmonary bed leads to pulmonary hypertension which results in right heart failure.
• The left ventricle is unaffected in pure mitral stenosis.

Causes

The cause of mitral stenosis is almost always rheumatic heart disease.

Differentiating Mitral stenosis from other Diseases

Mitral stenosis should be differentiated from:

• Cor triatriatum
• Atrial myxoma
• Pulmonary vein obstruction

Natural History and Complications

Natural History

Mitral stenosis is intermittently progressive and has a prolonged clinical course before becoming severe.

Complications

Complications occur in the late stages of mitral stenosis. They include:

• Atrial fibrillation
• Pulmonary hypertension
• Right heart failure
• Stroke - due to thrombus formation in the left atrium

Diagnosis

Symptoms

Symptoms of mitral stenosis occur late in the course of the disease as the disease progresses slowly over decades. Common symptoms include:

• Dyspnea
• Paroxysmal nocturnal dyspnea
• Orthopnea
• Hemoptysis
• Palpitations
• Emboli

Physical Examination

• A high pitched additional sound called opening snap may be heard after the A₂ component of S₂ and it signifies the forceful opening of the mitral valve.