Mitral Valve area < 2 cm2 causing increased left Atrial pressure. High pressure causes pulmonary hypertension and symptoms of right-sided heart failure.
More common in female, Rheumatic heart disease (most common), endocarditis, SLE
Loud S1, low-pitched rumbling mid-diastolic murmur loudest at apex in left lateral position, malar flush, AF, pulmonary oedema, raised JVP, may develop pulmonary regurgitation due to pulmonary HTN leading to early-diastolic Graham-Steele murmur
Dyspnoea, fatigue, orthopnoea, paroxysmal nocturnal dyspnoea, palpitations
ECG: Left Atrial Enlargement (P mitrale), Right ventricular hypertrophy. Right axis deviation
Chest X-Ray: Left Atrial Enlargement, pulmonary congestion, Mitral Valve calcification
Echo: Gold standard – assesses for valvular and leaflet abnormalities
Coronary angiography: concurrent CAD in patients if age > 45
Medical: Treat AF if present with rate/rhythm control and anticoagulation.
Treat right heart failure using diuretics and beta-blockers to increase filling time
Surgical: Mitral valve replacement or balloon valvotomy
Surgery has a good success rate.
Right-sided heart failure, AF, Stroke, Infective endocarditis, Tricuspid regurgitation
