MITRAL STENOSIS Stage 1: Mild mitral stenosis Asymptotic with physiological compensation. Following an episode of Rheumatic fever). Stenosis slowly occurs over a period of 20 to 30 years. The normal mitral valve area is 4-6 cm 2 (mitral valve index 4-4.5 cm 2 ). The patient remains essentially symptom-free during the period of stenosis till 1.5-2.5 cm 2 (valve index 1--2 cm 2 /m 2 ) is reached.
At this point moderate exercise induces dyspnoea. Exercise testing in the cardiac catheters laboratory, by detecting increased filling pressure with exercise can detect this stage. Further progression of the disease leads to increasing in left atrial pressure and volume that are reflected back into the pulmonary circuit Stage 2: Moderate mitral stenosis Symptomatic impairment between a valve area of 1-1.5 cm 2 increasing symptomatology appears with mild to moderate exertion. Severe congestive…
