RT Book, Section
A1 Bahl, Vinay K.
A1 Math, Ravi S.
A2 Fuster, Valentin
A2 Narula, Jagat
A2 Vaishnava, Prashant
A2 Leon, Martin B.
A2 Callans, David J.
A2 Rumsfeld, John S.
A2 Poppas, Athena
SR Print(0)
ID 1202446249
T1 Mitral Stenosis
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1202446249
RD 2024/04/23
AB Chapter  SummaryThis  chapter  discusses  the  etiology,  pathogenesis,  clinical  presentation,  diagnostic  modalities,  and  therapeutic  options  of  mitral  stenosis  (MS).  Rheumatic  MS  remains  prevalent  in  developing  countries  whereas  prevalence  of  degenerative  MS  has  increased  in  developed  countries.  The  hemodynamic  hallmark  of  MS  is  a  persistent  diastolic  gradient  between  the  left  atrium  and  left  ventricle.  Exertional  dyspnea  develops  after  a  long  asymptomatic  latent  period.  The  course  is  subsequently  complicated  by  heart  failure,  atrial  fibrillation,  thromboembolism,  and  hemoptysis.  Echocardiography  is  the  mainstay  of  diagnosis,  although  cardiac  catheterization  may  be  needed  to  establish  the  severity  in  doubtful  cases.  While  medical  therapy  can  relieve  the  symptoms  of  MS,  relief  of  the  mechanical  obstruction  is  needed  to  correct  the  underlying  hemodynamic  abnormality.  This  is  achieved  by  balloon  mitral  valvotomy  or  mitral  valve  replacement  in  those  with  favorable  or  unfavorable  anatomy,  respectively.  In  patients  with  degenerative  MS,  newer  therapies  in  the  form  of  percutaneous  transcatheter  mitral  replacement  are  being  evaluated.  A  concerted  global  effort  to  control  rheumatic  heart  disease  is  needed  to  reduce  the  prevalence  of  rheumatic  MS.