Mitral stenosis

Question 1

Define mitral stenosis

Answer 1

Mitral valve narrowing causing obstruction to blood flow from the left atrium to the ventricle

Question 2

What is the pathophysiology of mitral stenosis?

Answer 2

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Question 3

What is the aetiology of mitral stenosis?

Answer 3

Most common cause (90%):
- Rheumatic heart disease (inflammation → commissural fusion → narrowed valve opening)

Rarer causes:

• Congenital mitral stenosis
• SLE
• Rheumatoid arthritis
• Endocarditis
• Atrial myxoma (rare cardiac tumour)

Question 4

What is the epidemiology of mitral stenosis?

Answer 4

Incidence is declining in industrialized countries because of declining incidence of rheumatic fever

Question 5

What are the symptoms of aortic stenosis?

Answer 5

May be asymptomatic.
Presents with fatigue, shortness of breath on exertion or lying down (orthopnoea). Palpita-
tions (related to AF).
Rare symptoms: Cough, haemoptysis, hoarseness caused by compression of the left
laryngeal nerve by an enlarged left atrium