Mitral stenosis: Difference between revisions
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==Background== | ==Background== | ||
*Most | *Most common cause (~85%) is rheumatic fever | ||
*Chronic [[rheumatic disease]] uncommon in western world, but still very common in | *Chronic [[rheumatic disease]] uncommon in western world, but still very common in developing countries<ref>Lung B. Mitral stenosis still a concern in heart valve diseases. Archives of Cardiovascular Diseases | ||
Volume 101, Issue 10, October 2008, Pages 597–599.</ref> | Volume 101, Issue 10, October 2008, Pages 597–599.</ref> | ||
**USA | **USA - 0.25 per 1000 people | ||
**India and Pakistan | **India and Pakistan - 5 per 1000 people | ||
**Cambodia | **Cambodia - 21.5 per 1000 people | ||
**Mozambique | **Mozambique - 30.4 per 1000 people | ||
*Other etiologies: | *Other etiologies: | ||
**Stenotic annular calcification | **Stenotic annular calcification (~12%) | ||
**Congenital | ***Degenerative/age-related | ||
***Post-infectious | |||
**Congenital (~0.6%) | |||
***Annulus hypoplasia | |||
***Parachute | |||
***Double orifice | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 22:04, 12 March 2019
Background
- Most common cause (~85%) is rheumatic fever
- Chronic rheumatic disease uncommon in western world, but still very common in developing countries[1]
- USA - 0.25 per 1000 people
- India and Pakistan - 5 per 1000 people
- Cambodia - 21.5 per 1000 people
- Mozambique - 30.4 per 1000 people
- Other etiologies:
- Stenotic annular calcification (~12%)
- Degenerative/age-related
- Post-infectious
- Congenital (~0.6%)
- Annulus hypoplasia
- Parachute
- Double orifice
- Stenotic annular calcification (~12%)
Clinical Features
- Mid-diastolic murmur
- Symptoms and complications
- Exertional dyspnea
- PND
- Acute pulmonary edema
- Tricuspid regurgitation
- Cor pulmonale
- Hemoptysis (pulmonary htn > ruptured bronchial vein)
- Atrial fibrillation
- Thromboembolism
- Precipitants:
Evaluation
Differential Diagnosis
Valvular Emergencies
Management
- Diuretics
- Alleviates pulmonary congestion
- A-fib treatment
- Hemoptysis
- Consider transfusion / surgery consult
- Endocarditis prophylaxis after replacement
Complications
- Systemic emboli
- CHF
- Atrial fibrillation
- Endocarditis
See Also
References
- ↑ Lung B. Mitral stenosis still a concern in heart valve diseases. Archives of Cardiovascular Diseases Volume 101, Issue 10, October 2008, Pages 597–599.