TY - CHAP M1 - Book, Section TI - MITRAL STENOSIS 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. Y1 - 2017 N1 - T2 - Hurst's The Heart, 14e 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesscardiology.mhmedical.com/content.aspx?aid=1161731624 ER -