Mitral Valve Stenosis.

 

Mitral Stenosis.

Narrowing of the opening of the mitral valve (the valve that regulates blood flow from the left atrium into the left ventricle). this leads to obstruction of the valve that can be mild, moderate or severe.

Aetiology

1.Rheumatic fever.

2. Congenital heart disease: Associated with atrial septal defect in Lutembacher’s syndrome.

3.Left atrial tumour.

Clinical features:

1.The patient may be totally asymptomatic and the condition may be diagnosed when the patient presents for some other reason.

2.Breathlessness on exertion.

3.Orthopnoea: The patient has to sit up so as to be able to breathe.

4.Bronchitis: It is due to congestion of the lungs.

5.Haemoptysis.

6.Cyanosis.

7.Easy fatigability.

8.Oedema feet.

9.Elevation of jugular venous pressure.

10.Palpitations.

11.Right ventricular heave on palpation.

12.Mid- diastolic murmur with presystolic accentuation, and an opening snap on auscultation.

 

Investigation

1.Chest X-ray.

2.ECG.

3.Echocardigraphy.

 

Treatment

It may be medical or surgical.

 

Closed mitral commissurotomy.

Treatment	Features
Treatment of pulmonary oedema	.Oxygen .Furosemide as a diuretic to remove the fluid in the lungs.
Treatment of bronchitis	.Antibiotics.
Treatment of associated anaemia	.Iron and folic acid.
Treatment of arrhythmias	.Digoxin for atrial fibrillation.
Closed mitral commissurotomy	.As an elective measure as well during an emergency, to enlarge the opening of the mitral valve.
Open mitral commissurotomy	.when a previous closed mitral commissurotomy has failed, or the mitral valve is calcific, and unlikely to respond to a closed commissurotomy.
Balloon mitral valvotomy	It is a recent method of treatment of mitral stenosis, in which the opening of the mitral valve is enlarged using a balloon catheter passed into the heart through a blood vessels in the periphery.

      

Complications

1.Atrial fibrillation.

2.Atrial flutter.

3.Cardiac failure.

4.Embolism.