Mitral Stenosis

Question 1

What are the causes of mitral stenosis?

Answer 1

Rheumatic Heart Disease (99%), Prosthetic Valve, Congenital (Rare)

Question 2

How to patients with mitral stenosis present?

Answer 2

SOB, fatigue, pulmonary oedema/haemoptysis, right heart failure, mitral facies (due to low CO)

Question 3

What is the pulse rate, rhythm, volume and character in mitral stenosis?

Answer 3

AF

Question 4

What happens to the internal jugular in mitral stenosis:?

Answer 4

Right heart failure causing raised JVP

Question 5

What is the apex beat in mitral stenosis?

Answer 5

Tapping apex

Question 6

What is felt on palpation in mitral stenosis?

Answer 6

Right ventricular heave

Question 7

What is heard on auscultation in mitral stenosis?

Answer 7

Low rumbling mid-diastolic murmur best heard at the apex on left hand side with expiration (using the bell) with no radiation. There is an opening snap with a loud 1st heart sound

Question 8

What is the pathology of mitral stenosis?

Answer 8

High left atrial pressure leading to pulmonary hypertension, leading to right ventricular hypertrophy, leading to tricuspid regurgitation, leading to right heart failure