General Medicine

Mitral Valve Stenosis

Obstruction or narrowing of the Mitral valve.
As the name suggests:

Mitral Valve Stenosis - Courtesy
  • Mitral valve: Valve in the heart,
  • Stenosis: Abnormal narrowing in a blood vessel

The valve orifice is slowly diminished by progressive fibrosis, leaflet calcification and fusion of the cusps and sub valvular apparatus.
Restricted blood flow from the left atrium to left ventricle causes rise in left atrial pressure, leading to pulmonary venous congestion and breathlessness. this leads to decrease in Cardiac Output which further leads to breathlessness and fatigue.
Clinical Features:

  1. Effort related Dyspnoea
  2. Acute Pulmonary Edema
  3. Haemoptysis
  4. Systemic Embolism
  5. Malar Flush may be apparent
  6. Apex beat is tapping in nature
  7. On Auscultation there may be a loud sound, an opening sound and a low pitched mid diastolic murmur
  8. Tricuspid regurgitation is seen which signify the presence of Pulmonary Hypertension


  • ECG: Shows bifid P waves due to left pulmonary hypertrophy
  • CXR: Enlarged left atrium and features of Pulmonary congestion
  • Echocardiography: Shows definite evaluation of Mitral Stenosis


  • Medical management consists of Diuretics for pulmonary Congestion
  • Anticoagulants and rate limiting agents in presence of Atrial Fibrillation
  • Valve Replacement
  • Balloon Valvuloplasty
  • Valvotomy

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