Mitral stenosis

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

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.