RT Book, Section
A1 Bahl, Vinay K.
A1 Math, Ravi S.
A1 Carabello, Blase A.
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1161731624
T1 MITRAL STENOSIS
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accesscardiology.mhmedical.com/content.aspx?aid=1161731624
RD 2024/04/19
AB Worldwide,  most  cases  of  mitral  stenosis  (MS)  are  caused  by  rheumatic  heart  disease  (RHD)  (Fig.  50–1).1  However,  rheumatic  fever  has  become  quite  rare  in  developed  nations  and  so  too  has  MS.  Indeed,  most  MS  in  the  United  States  occurs  in  patients  who  have  emigrated  here  from  countries  where  rheumatic  fever  is  still  commonplace.  Why  rheumatic  fever  has  waned  in  developed  nations  is  unclear.  Although  antibiotic  use  almost  certainly  plays  a  role,2  the  decline  in  disease  incidence  began  before  antibiotics  were  widely  available,  suggesting  that  socioeconomic  factors  also  play  a  key  role  in  the  disease  process.  In  addition,  the  organism  responsible  (group  A  Streptococcus)  itself  may  have  mutated  to  a  less  rheumatologic  agent.  Degenerative  calcific  MS  may  be  confused  with  rheumatic  MS.  Although  the  incidence  of  degenerative  calcific  MS  increases  in  the  very  elderly,  the  MS  is  most  often  mild  to  moderate,  and  does  not  require  intervention.