Mitral Valve Stenosis: Signs, Symptoms, and Diagnosis

Mitral Valve Stenosis: Signs, Symptoms, and Diagnosis

Question. Enumerate clinical and diagnostic features of mitral stenosis.
Answer.

Clinical Features Features Of Mitral Stenosis

1. The patient complains of breathlessness and fatigue on exertion.
2. of stenosis leads to dyspnea on rest and even orthopnea and paroxysmal nocturnal dyspnea.
3. Acute pulmonary edema can also occur.
4. Hemoptysis can be present due to rupture of pulmonary congestion and pulmonary embolism and cough due to pulmonary congestion.
5. Chest pain is present due to pulmonary venous hypertension.

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Signs Features Of Mitral Stenosis

1. Atrial firillation is present.
2. Auscultation: Presence of loud first heart sound, opening snap, and mid-diastolic low-pitched rumbling murmur best heard at the apex.
3. Signs of raised pulmonary capillary pressure: Pleural effusion, crepitation, pulmonary edema.
4. Signs of pulmonary hypertension: RV heave, Loud P2
5. Others: Basal crackles, ascites, and pleural effusion Diagnostic Features

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Investigations Of Mitral Stenosis

1. ECG:

1. Right ventricular hypertrophy
2. Left atrial hypertrophy

2. X-ray chest:

1. A prominent left atrial appendage may be seen in the left border of the heart between the pulmonary artery and the left ventricle.
2. It indicates left atrial enlargement.
3. Double shadow of the enlarged left atrium on the right side of the spine.
4. Signs of pulmonary venous congestion.

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3. Echocardiogram:

1. Show thick immobile mitral cusp
2. Decreased diastolic filling of left ventricle
3. Decreased valve orifice area
4. Left atrial thrombus, if it is present.

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4. Cardiac catheterization: is used to assess valvular lesions and to detect coronary artery disease.

5. Doppler:

1. The pressure gradient across the mitral valve
2. Pulmonary artery pressure
3. Left ventricular function