Mitral stenosis or mitral valve stenosis is a valve disease (valvular heart disease) characterized by an abnormal narrowing of the mitral valve orifice of the heart . This reduction of the valve orifice is caused by an inflammatory process that can also affect the valve’s supporting apparatus. It can also be, although in few cases, of congenital origin.
Summary
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- 1 Pathogenesis
- 1 Congenital
- 2 Acquired
- 2 Diagnosis
- 3 Treatment
- 4 Source
- 5 External links
Pathogeny
The rheumatic fever is the most common cause, but sometimes not the clinical history of the disease is required. Fibrosis occurs with thickening and fusion of the commissures and frequently calcification . it is more frequent in the female sex . Its interatrial communication association is known as Lutembacher syndrome . Other less frequent causes can be:
Congenital
It is associated with other cardiac malformations. Its prognosis is serious, with high mortality in childhood of congenital origin is the triatria heart, in which there is a diaphragm in the left atrium that behaves like a supravalvular stenosis.
Acquired
Among them are:
- AI tumors especially myxoma.
- Thrombi in AI .
- Carcinoid tumor , as a systemic complication in its evolution.
Diagnosis
Unlike the other valve diseases , the clinical manifestations of MS are earlier, especially in patients from tropical and subtropical areas, although there may be periods of 15 to 20 years without symptoms.
the main symptom is dyspnea , secondary to venous hypertension and pulmonary congestion . It can be triggered by any circumstance that increases the flow through the stenotic mitral valve, either by increasing the CG or by shortening the LV diastolic filling phase, such as physical exertion, emotional tension, fever , pregnancy , atrial fibrillation with rapid ventricular response .
Treatment
Treatment options for mitral stenosis include medical management, surgical valve replacement, and percutaneous balloon valvuloplasty .
Mitral stenosis typically progresses slowly (a matter of decades) from the initial signs until the symptoms of atrial fibrillation appear (class 2) and then to the more severe classes III and IV. Once the symptoms of severe classes of stenosis appear, the progression of the disease becomes accelerated and the patient’s condition deteriorates. The indication of an invasive treatment, either replacement or valvuloplasatia is justified in class III or IV symptoms.
To determine which patients would benefit from percutaneous balloon valve disease, a scoring system was developed, based on four echocardiographic criteria: leaflet mobility, leaflet thickness, subvalve inflammation, and calcification. Those with a score ≥ 8 tend to have suboptimal results. Good results have been seen with valve disease in individuals with scores <8 and without calcium at the corners.
