Recognition and management of mitral stenosis.
Mitral stenosis may be recognized simply on routine physical examination from abnormalities on auscultation, which are subsequently confirmed by Doppler echocardiographic examination. The diagnosis may also be suspected in patients in whom the history is suggestive of rheumatic fever and in whom physical diagnosis reveals findings indicative of mitral stenosis. Occasional cases of mitral stenosis are picked up in the Doppler echocardiography laboratory when a patient has not been suspected of having mitral stenosis but in whom a routine echocardiogram has been taken, for whatever reason. If there is any doubt about the presence of mitral stenosis, confirming the presence of a diastolic pressure gradient across the mitral valve during cardiac catheterization permits one to make a definitive diagnosis as well as estimate the area of the stenotic valve orifice. Intervention with either surgery or balloon valvotomy is indicated when the mitral valve area falls to < or = 1.2 cm2 in a symptomatic patient.
Rapaport
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San Francisco General Hospital, University of California, Cardiology Division, CA 94110.
D015150:Echocardiography, Doppler; D006326:Heart Auscultation; D006347:Heart Sounds; D006801:Humans; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy