Mitral Valve area < 2 cm2causing increased left Atrial pressure. High pressure causes pulmonaryhypertension and symptoms of right-sided heart failure.
More common in female,
Rheumaticheart disease (most common), endocarditis, SLE
Dyspnoea, fatigue, orthopnoea,paroxysmal nocturnal dyspnoea, palpitations
Loud S1, low-pitchedrumbling mid-diastolic murmur loudest at apex in left lateral position, malarflush, AF, pulmonary oedema, raised JVP, may develop pulmonary regurgitationdue to pulmonary HTN leading to early-diastolic Graham-Steele murmur
ECG: Left Atrial Enlargement (Pmitrale), Right ventricular hypertrophy.Right
Chest X-Ray: Left Atrial Enlargement,pulmonary congestion, Mitral Valve
Echo: Gold standard – assesses for valvular andleaflet abnormalities
Coronary angiography: concurrent CAD in patients if age> 45
Medical: Treat AF if present with rate/rhythmcontrol and anticoagulation.
Treat right heart failure using diuretics andbeta-blockers to increase
Surgical: Mitral valve replacement or balloonvalvotomy
Right-sided heart failure, AF, Stroke,Infective endocarditis, Tricuspid
Surgery has a goodsuccess rate.
Bifid P-Wave (P-Mitrale)
Figure 1.15 P-Mitrale
Join Shiken For FREEJoin For FREE