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Modern Management of Mitral Stenosis

Although once rheumatic fever and its consequences were the major cause of valvular heart disease in the developed world, this disease has become exceedingly rare today. As a consequence, mitral stenosis (MS), which is usually caused by rheumatic fever, has also become rare. In fact, MS is most commonly found in the United States in patients who have emigrated here from areas where rheumatic fever is still endemic... Although the attack rate for rheumatic fever is roughly equal among genders, MS is 2 to 3 times more common in women. It is generally believed that the M protein antigen held in common between the heart and group A hemolytic Streptococcus results in an autoimmune attack of the…

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Articles of Interest

Current Evaluation and Management of Patients With Mitral Stenosis

In almost all patients, MS is the result of previous rheumatic carditis with valve involvement.

Management of mitral stenosis: a systematic review of clinical practice guidelines and recommendations

There was consensus for percutaneous mitral balloon commissurotomy as first-line treatment of symptomatic severe rheumatic MS with suitable anatomy.

Mitral stenosis

Mitral stenosis causes obstruction to blood flow from the left atrium to the left ventricle. This results in a backlog of blood before the valve, leading to symptoms such as atrial enlargement (which can cause atrial fibrillation and embolism), lung congestion (resulting in cough and dyspnea), and in severe cases, pulmonary edema. It's most commonly caused by rheumatic heart disease. Treatment for severe or symptomatic cases often involves balloon valvuloplasty or transcatheter/surgical valve replacement.

Mitral valve stenosis: epidemiology and causes in elderly patients

Mitral stenosis in the elderly is an evolving and complex pathological entity. The prevalence of rheumatic disease in developing countries is important and, due to migration, it continues to be seen as the first cause of mitral stenosis in developed countries. This remains the case despite improvements in prophylaxis, prompt diagnosis and early treatment. Secondly, the massive increase in the elderly population with a high prevalence of comorbidities and cardiovascular risk factors fosters chronic calcific degeneration. This change in population and causes is reflected in the characteristics and importance of mitral stenosis and is leading to an evolution in diagnosis and treatment.

Problem: Mitral Valve Stenosis

Although medications can’t fix a valve defect, they can help with symptoms. Your health care team may prescribe diuretics to reduce fluid accumulation in the lungs, blood thinners* to prevent clots from forming or drugs to control the heart rhythm if those are indicated. The mitral valve can usually be repaired or replaced with surgery or a minimally invasive procedure.

Resources

StatPearls

The most common cause of mitral stenosis is rheumatic fever. Uncommon causes of mitral stenosis are calcification of the mitral valve leaflets and congenital heart disease. Other causes of mitral stenosis include infective endocarditis, mitral annular calcification, endomyocardial fibroelastosis, malignant carcinoid syndrome, systemic lupus erythematosus, Whipple disease, Fabry disease, and rheumatoid arthritis.