Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Mitral valve stenosis ++ 394.0 Mitral stenosis394.2 Mitral stenosis with insufficiency396.0 Mitral valve stenosis and aortic valve stenosis396.1 Mitral valve stenosis and aortic valve insufficiency746.5 Congenital mitral stenosis ++ I05.0 Rheumatic mitral stenosisI05.2 Rheumatic mitral stenosis with insufficiencyI34.2 Nonrheumatic mitral (valve) stenosisQ23.2 Congenital mitral stenosis ++ 6D: Impaired aerobic capacity/endurance associated with cardiovascular pump dysfunction or failure1 +++ Description ++ Narrowing of the mitral valve2Causes reduced blood flowLimited blood flow between left atrium and left ventricleIncreased volume and pressure of left ventricleAtrial fibrillation and dysrhythmia-induced thrombiDecreased blood flow can cause decreased cardiac output (CO) leading to lightheadedness, fainting, chest painDecreased blood flow to the rest of the body and brainFour types2RheumaticCalcificCongenitalCollagen-vascular disease +++ Essentials of Diagnosis ++ Stethoscope auscultation for murmur on carotid artery; bruit soundEKG/ECG2EchocardiogramCardiac catheterizationChest x-rayExercise stress test +++ General Considerations ++ Worsens over time, neither exercise or diet improves the stenosisEducation on disease management reduces hospitalizationPatients with significant mitral stenosis should not participate in competitive sportsStrenuous activity should be limited for symptomatic mitral valve stenosisSigns and symptoms should be monitoredEmphasis on wellness and prevention +++ Demographics ++ Affects women twice as often as menOccurs in only 40% of all rheumatic heart disease casesCan be congenital, present from birthCan be caused by age-induced dysfunction of the valve from calcification or atherosclerosisMore common in patients with history of rheumatic fever +++ Signs and Symptoms ++ Pulmonary hypertensionPulmonary edemaRight ventricular failureDecreased COPeripheral edemaCough with pink, frothy sputumDyspnea on exertionHemoptysisShortness of breath2Anginal chest pain that increases with exerciseOrthopnea2Fatigue, weakness2Fainting, dizziness with activityPalpitationsDysphagiaHoarseness +++ Functional Implications ++ Symptoms depend on degree of stenosisMild-to-moderate stenosis generally does not cause symptomsSevere mitral stenosis causes progressive shortness of breath and increased risk of left atrial overloadMinimial at first and patients may be unaware of reduced cardiovascular capacity until it becomes severeHigher risk of atrial arrhythmias and embolic eventsCan cause syncope, chest pain, heart failure, deadly cardiac arrhythmias if untreated +++ Possible Contributing Causes ++ Causes of mitral stenosis2Age-related calcification of mitral valveCongenital valve dysfunctionRheumatic feverRecurrent strep infectionsUse of medications such as ergot preparationCongenital heart defectBlood clots or tumor can block mitral valveRadiation exposure to chestSystemic lupus erythematosusRheumatoid arthritisCoronary artery diseaseHyperlipoproteinemiaHypertensionDiabetes mellitusOlder age +++ Differential Diagnosis ++ Acute coronary syndromeMitral regurgitationAortic stenosis... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.