Mitral stenosis: Difference between revisions
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==Background== | ==Background== | ||
*Most common cause (~85%) is rheumatic fever | |||
*Chronic [[rheumatic disease]] uncommon in western world, but still very common in developing countries<ref>Lung B. Mitral stenosis still a concern in heart valve diseases. Archives of Cardiovascular Diseases | |||
Volume 101, Issue 10, October 2008, Pages 597–599.</ref> | |||
**USA - 0.25 per 1000 people | |||
**India and Pakistan - 5 per 1000 people | |||
**Cambodia - 21.5 per 1000 people | |||
**Mozambique - 30.4 per 1000 people | |||
*Other etiologies: | |||
**Stenotic annular calcification (~12%) | |||
***Degenerative/age-related | |||
***Post-infectious | |||
**Congenital (~0.6%) | |||
***Annulus hypoplasia | |||
***Parachute | |||
***Double orifice | |||
==Clinical Features== | ==Clinical Features== | ||
*Mid-diastolic [[murmur]] | *Mid-diastolic [[murmur]] | ||
*Symptoms | *Symptoms and complications | ||
**Exertional dyspnea | **Exertional dyspnea | ||
**PND | **PND | ||
**Acute [[pulmonary edema]] | **Acute [[pulmonary edema]] | ||
** | **[[Tricuspid regurgitation]] | ||
**Hemoptysis ( | **[[Cor pulmonale]] | ||
**Hemoptysis (pulmonary htn > ruptured bronchial vein) | |||
**[[Atrial fibrillation]] | |||
**Thromboembolism | |||
**Precipitants: | **Precipitants: | ||
***[[Anemia]] | ***[[Anemia]] | ||
| Line 15: | Line 33: | ||
***[[A-fib]] | ***[[A-fib]] | ||
== | ==Evaluation== | ||
*[[ECG]] | *[[ECG]] | ||
**RAD | **RAD | ||
**Biphasic P waves | **Biphasic P waves | ||
**Most common arrhythmia is AF | |||
*[[CXR]] | *[[CXR]] | ||
**Straightening of right heart border | **Straightening of right heart border | ||
*Echo | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Valvular emergencies DDX}} | {{Valvular emergencies DDX}} | ||
== | ==Management== | ||
*[[Diuretics]] | *[[Diuretics]] | ||
**Alleviates pulmonary congestion | **Alleviates pulmonary congestion | ||
| Line 41: | Line 61: | ||
*[[Valvular Emergencies]] | *[[Valvular Emergencies]] | ||
*[[Heart Murmurs]] | *[[Heart Murmurs]] | ||
==References== | |||
<references/> | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
Revision as of 22:04, 12 March 2019
Background
- Most common cause (~85%) is rheumatic fever
- Chronic rheumatic disease uncommon in western world, but still very common in developing countries[1]
- USA - 0.25 per 1000 people
- India and Pakistan - 5 per 1000 people
- Cambodia - 21.5 per 1000 people
- Mozambique - 30.4 per 1000 people
- Other etiologies:
- Stenotic annular calcification (~12%)
- Degenerative/age-related
- Post-infectious
- Congenital (~0.6%)
- Annulus hypoplasia
- Parachute
- Double orifice
- Stenotic annular calcification (~12%)
Clinical Features
- Mid-diastolic murmur
- Symptoms and complications
- Exertional dyspnea
- PND
- Acute pulmonary edema
- Tricuspid regurgitation
- Cor pulmonale
- Hemoptysis (pulmonary htn > ruptured bronchial vein)
- Atrial fibrillation
- Thromboembolism
- Precipitants:
Evaluation
Differential Diagnosis
Valvular Emergencies
Management
- Diuretics
- Alleviates pulmonary congestion
- A-fib treatment
- Hemoptysis
- Consider transfusion / surgery consult
- Endocarditis prophylaxis after replacement
Complications
- Systemic emboli
- CHF
- Atrial fibrillation
- Endocarditis
See Also
References
- ↑ Lung B. Mitral stenosis still a concern in heart valve diseases. Archives of Cardiovascular Diseases Volume 101, Issue 10, October 2008, Pages 597–599.