RT Book, Section A1 Le, D. Elizabeth A2 Crawford, Michael H. SR Print(0) ID 1139745258 T1 Mitral Stenosis T2 CURRENT Diagnosis & Treatment: Cardiology, 5e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9781259641251 LK accesscardiology.mhmedical.com/content.aspx?aid=1139745258 RD 2024/10/14 AB ESSENTIALS OF DIAGNOSISExertional dyspnea and fatigue.Opening snap, diastolic rumble murmur, loud S1, presystolic accentuated murmur.Right ventricular heave and loud P2 if pulmonary hypertension and right heart failure are present.A2-OS interval ≤ 80 ms in severe mitral stenosis.Sinus rhythm or atrial fibrillation, notched P wave or P mitrale in leads II and III and/or biphasic P wave in V1, right axis deviation, high amplitude of P wave in lead II, and large R wave in V1 on electrocardiography.Flattening of left atrial border and/or double density, elevated left main bronchus, enlarged pulmonary arteries, and Kerley B lines on chest radiography.Thickened and/or calcified mitral leaflets and subvalvular apparatus resulting in “hockey-stick” motion of the anterior leaflet and fusion of commissures resulting in fish-mouth appearance of the rheumatic mitral valve on two- and three-dimensional echocardiography.Reduced mitral valve area by planimetry on two- or three-dimensional echocardiography and by pressure half-time, continuity equation, and proximal isovelocity surface area quantification methods on Doppler echocardiography and increased mean transmitral valve gradient on Doppler echocardiography.