Mitral stenosis

Background

  • Most likely cause is rheumatic fever, ~85%
  • Chronic rheumatic disease uncommon in western world, but still very common in underdeveloped 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, aging, post-infection)
    • Congenital, rare at ~0.6% (annulus hypoplasia, parachute, double orifice)

Clinical Features

Evaluation

  • ECG
    • RAD
    • Biphasic P waves
    • Most common arrhythmia is AF
  • CXR
    • Straightening of right heart border
  • Echo

Differential Diagnosis

Valvular Emergencies

Management

  • Diuretics
    • Alleviates pulmonary congestion
  • A-fib treatment
  • Hemoptysis
    • Consider transfusion / surgery consult
  • Endocarditis prophylaxis after replacement

Complications

See Also

References

  1. Lung B. Mitral stenosis still a concern in heart valve diseases. Archives of Cardiovascular Diseases Volume 101, Issue 10, October 2008, Pages 597–599.