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Mitral Stenosis

Gene Pershwitz, MD and Harish C. Devineni, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • 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...

DIAGNOSIS

HISTORY

  • 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

GENERAL MEASURES

  • 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,...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • 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...

REFERENCES

1
Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Ass...

CODES

ICD10

  • 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...

CLINICAL PEARLS

  • 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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