Evaluation of the severity of mitral stenosis in patient with pulmonary hypertension: Role of exercise hemodynamics

Abstract

Dyspnea due to mitral stenosis (MS) and/or pulmonary hypertension (PHT) in patients who may have both conditions presents a challenging diagnostic dilemma. The hemodynamic response to exercise is probably the most helpful method to arrive at the correct diagnosis and treatment algorithm. In this hemodynamic rounds discussion, we evaluated a patient with MS and PHT prior to the decision for mitral valvuloplasty. Key Points Symptoms in patients with mitral stenosis and pulmonary hypertension cannot always be attributed to one pathology. Catheter‐based hemodynamics are often needed to differentiate valve from lung disease. Exercise hemodynamics can clarify the predominant pathology in complex clinical scenarios.