Mitral Stenosis Flashcards
Define Mitral Stenosis?
Mitral Valve narrowing causing obstruction to blood flow from the left atrium to the left ventricle
What is the epidemiology of Mitral Stenosis?
Incidience is decling because rheumatic fever is becoming more and more rare
What is the main cause of Mitral Stenosis?
Rheumatic Heart Disease (90% of cases)
What are some of the rarer causes of Mitral Stenosis?
Congenital Mitral Stenosis SLE Rheumatoid Arthritis Endocarditis Atrial Myxoma
What are the presenting symptoms of Mitral Stenosis?
May be asymptomatic Fatigue Shortness of breath on exertion Orthopnoea Palpitations (related to AF)
What are the rarer symptoms of Mitral Stenosis?
Cough
Haemoptysis
Hoarseness caused by compression of left recurrent laryngeal nerve by an enlarged left atrium
What are the signs of Mitral Stenosis on physical examination?
Peripheral Cyanosis Malar Flush Irregularly Irregular Pulse (if in AF) Apex beat undisplaced and tapping Parasternal heave Loud S1 with opening snap Mid-diastolic murmur Evidence of pulmonary oedema on lung auscultation (if decompensated)
What is the cause of Parasternal Heave in Mitral Stenosis?
Due to right ventricular hypertrophy secondary to pulmonary hypertension
What would we see on an ECG for Mitral Stenosis?
May be normal
May see p mitrale (broad bifid p wave caused by left atrial hypertrophy)
May see AF
Evidence of right hypertrophy may be seen if there is severe pulmonary hypertension
What would we see on an CXR for Mitral Stenosis?
Left atrial enlargement
Cardiac enlargement
Pulmonary congestion
Mitral Valve calcification (occurs in rheumatic cases)
What would we see on Echocardiography for Mitral Stenosis?
Assesses functional and structural impairments Transoesophageal echocardiogram (TOE) gives a better view
