Mitral Stenosis

Mitral Stenosis


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

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