What is Mitral Stenosis?

In normal adults, the Mitral valve between the left atrium and left ventricle has an orifice of 4-6 sq. cm. When the orifice is less than half of the normal, blood flow between the left atrium and left ventricle is significantly obstructed. A characteristic finding of mitral stenosis is a localized mid-diastolic murmur low in pitch whose duration varies with the severity of the stenosis and the heart rate. Because it is thickened, the valve opens in early diastole with an opening snap. The sound is sharp, is widely distributed over the chest, and occurs early after A2 in severe and later in milder varieties of mitral stenosis. In severe mitral stenosis with low flow across the mitral valve, the murmur may be soft and difficult to find, but the opening snap can usually be heard. If the patient has both mitral stenosis and mitral regurgitation, the dominant features may be the systolic murmur of mitral regurgitation with or without a short diastolic murmur and a delayed opening snap.

Treatment of Mitral Stenosis

Mitral stenosis may be present for a lifetime with few or no symptoms, or it may become severe in a few years. In most cases, there is a long asymptomatic phase, followed by subtle limitation of activity. Pregnancy and its associated increase in cardiac output and the transmitral pressure gradient often precipitate symptoms. The onset of atrial fibrillation often precipitates more severe symptoms, which usually improve with control of the ventricular rate or restoration of sinus rhythm.

Clinical Features of Mitral Stenosis

  • Adults between 30-40 years of age.
  • Patients may be without symptoms.
  • As the Mitral valve orifice gets narrower, the patient develops breathlessness, cough, blood in sputum, nocturnal dyspnea, lung edema, irregular heartbeats, cyanosis.

Management of Mitral Stenosis

  • Consult a physician.
  • Mitral valvotomy (widening of stenosis).
  • Mitral valve replacement.

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