RT Book, Section A1 Le, D. Elizabeth A2 Crawford, Michael H. SR Print(0) ID 1198113132 T1 Mitral Stenosis T2 Current Diagnosis & Treatment: Cardiology, 6e YR 2023 FD 2023 PB McGraw Hill Education PP New York, NY SN 9781264643578 LK accesscardiology.mhmedical.com/content.aspx?aid=1198113132 RD 2024/03/29 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 rheumatic valve disease.Calcification of the mitral annulus with extension to the basal mitral leaflets without commissural fusion resulting in tubular narrowing from the annulus to the leaflet tips on two- and three-dimensional echocardiography in degenerative calcific mitral stenosis.Mitral valve area ≤ 1.5 cm2 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 elevated mean transmitral valve gradient on Doppler echocardiography.