Mitral stenosis: etiology and mechanism of disease, physiological change, symptoms and diagnostic evaluation

Abstract

Valvular heart disease is a common health problem and affects the quality of life. The mitral valve is the most often diseased of all cardiac valves, particularly with its proclivity to rheumatic process involvement. Mitral stenosis is frequently caused by rheumatic fever, which produces fibrosis, thickening and calcification. The etiologic agent for rheumatic fever is Group A beta-Hemolytic Streptococcus, but the specific mechanisms leading to the valvulitis are unknown. The mitral valve orifice is approximately 4 to 6 cm2 in the normal adult. When mitral stenosis occurs, it produces three significant events: an increase in left atrial mean pressure, an increase in pulmonary vascular resistance, and a decrease in cardiac output. The symptoms of mitral stenosis are related to the degree of valvular dysfunction and to disturbance in the cardiac rhythm. The most characteristic symptom is dyspnea. Atrial dysrhythmias, such as atrial fibrillation, occur frequently in mitral stenosis and are associated with thrombus formation, which is a risk for the thromboembolism event. Diagnostic evaluation methods comprise history taking, physical examination, chest radiography, echocardiography, and cardiac catheterization in some indicated patients.

Keywords

• valvular heart disease
• mitral stenosis
• rheumatic fever
• atrial dysrhythmias
• thromboembolism
• echocardiography
• cardiac catheterization