The mitral apparatus is made up of the apparatus, anterior and posterior leaflets which are attached to the anterolateral and posteromedial papillary muscles via the chordae.
Mitral s...
History of rheumatic fever
Severity depends on valve area; most early cases will be asymptomatic.
Mean age of symptom onset in rheumatic valvular disease is in the late 30s to 40s. Late...
Treatment is dependent on severity of stenosis and symptoms.
Patients who have a valvular area >1.5 cm2 and no symptoms can be managed medically
MS is generally progressive,...
Counsel patients that MS usually is slowly progressive but can have sudden onset of atrial fibrillation, which could become rapidly fatal. Call 911 for marked wor...
I05.0 Rheumatic mitral stenosis
I05.8 Other rheumatic mitral valve diseases
I34.2 Nonrheumatic mitral (valve) stenosis
I05.2 Rheumatic mitral stenosis with insufficiency
Q23.2 Congenital mitral...
Asymptomatic patients may be followed clinically with yearly exams for development of symptoms with periodic echo to evaluate valve area.
Once symptoms of MS develop, initiate appropria...
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<bold>FIGURE 11-31. Chronic rheumatic valvulitis.</bold> A view of a surgically excised rheumatic mitral valve from the left atrium (<bold>A</bold>) and left ventricle (<bold>B</bold>) shows rigid, thickened, and fused leaflets with a narrow orifice, creating the characteristic "fish mouth" appearance of rheumatic mitral stenosis. Note that the tips of the papillary muscles <italic>(shown in B)</bold> are directly attached to the underside of the valve leaflets, reflecting marked shortening and fusion of the chordae...
<bold>FIGURE 11-31. Chronic rheumatic valvulitis.</bold> A view of a surgically excised rheumatic mitral valve from the left a...