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Mitral stenosis
From WikEM
Contents
Background
- Most likely cause is rheumatic fever, ~85%
- Chronic rheumatic disease uncommon in western world, but still very common in underdeveloped countries[1]
- USA, 0.25 per 1000 people
- India and Pakistan, 5 per 1000 people
- Cambodia, 21.5 per 1000 people
- Mozambique, 30.4 per 1000 people
- Other etiologies:
- Stenotic annular calcification, ~12% (degenerative, aging, post-infection)
- Congenital, rare at ~0.6% (annulus hypoplasia, parachute, double orifice)
Clinical Features
- Mid-diastolic murmur
- Symptoms and complications
- Exertional dyspnea
- PND
- Acute pulmonary edema
- Tricuspid regurgitation
- Cor pulmonale
- Hemoptysis (pulmonary htn > ruptured bronchial vein)
- Atrial fibrillation
- Thromboembolism
- Precipitants:
Evaluation
Differential Diagnosis
Valvular Emergencies
- Mitral stenosis
- Mitral regurgitation
- Aortic stenosis
- Aortic regurgitation
Management
- Diuretics
- Alleviates pulmonary congestion
- A-fib treatment
- Hemoptysis
- Consider transfusion / surgery consult
- Endocarditis prophylaxis after replacement
Complications
- Systemic emboli
- CHF
- Atrial fibrillation
- Endocarditis
See Also
References
- ↑ Lung B. Mitral stenosis still a concern in heart valve diseases. Archives of Cardiovascular Diseases Volume 101, Issue 10, October 2008, Pages 597–599.
Authors
Kevin Lu, Ross Donaldson, Daniel Eggeman, Daniel Ostermayer, Neil Young
