Mitral Stenosis

Question 1

What is mitral stenosis?

Answer 1

Narrowing of the mitral valve, which progresses over long periods of time

Question 2

What are the clinical symptoms of mitral stenosis?

Answer 2

Dyspnoea
Cough with hemoptysis
Chest pain
Red flushing over the cheeks
Infective endocarditis
Hoarse voice (compression of recurrent laryngeal nerve)

Question 3

What are the clinical presentations of mitral stenosis?

Answer 3

Mitral fancies (bilateral cyanosis or flushing over cheeks)
Pulse is normal unless AF
Tapping apex beat
Right ventricular heave (right ventricular hypertrophy)
Diastolic thrill
Distention of the jugular veins (JVP = prominent a wave)

Question 4

What clinical investigations what you carry out to diagnose mitral stenosis?

Answer 4

ECG
CXR
Cardiac catheterization
Echocardiography
Cardiac magnetic resonance

Question 5

What size does the orifice have to decrease to in order to cause complications?

Answer 5

If the mitral orifice decreases below 2cm then this causes consequences

Question 6

what is the aetiology of mitral stenosis?

Answer 6

Rheumatic heart disease

systemic conditions i.e. SLE,, Rheumatoid arthuritis, congenital mitral stenosis

Question 7

what is the treatment for mitral stenosis if they also have atrial fibrillation?

Answer 7

anti-arrythmics
Beta blockers / CCB’s to slow heart rate
ventricular rate control
anti coagulation (high risk of developing a clot)

Question 8

describe the pathophysiology of mitral stenosis.

Answer 8

all the blood isn’t able to pass into the ventricle so this increases left atrial pressure
the atrial-ventricular pressure gradient will increase
pulmonary venous and capillary pressure increases causing oedema
left ventricular and systolic pressure is normal