The spectrum of pure mitral stenosis

Hugenholtz, Paul G.; Ryan, Thomas J.; Stein, Samuel W.; Abelmann, Walter H.

doi:10.1016/0002-9149(62)90171-6

Cited by 128 publications

(14 citation statements)

References 30 publications

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“…(11,12) The normal mitral valve area is 4-6cm 2 and symptoms usually do not develop until the valve area is less than 2.5cm 2 ; (7,13) a valve area >1.5cm 2 usually does not produce symptoms at rest. (14) Development of symptoms or pulmonary hypertension in mitral stenosis is associated with a poor outcome if left untreated. (12) The pressure gradient across the mitral valve is a function of the square of the flow across the valve and is dependent on the diastolic filling period.…”

Section: Mitral Stenosismentioning

confidence: 99%

“…(7,11) Therefore, symptoms in mitral stenosis are usually precipitated by an increase in flow or heart rate and the degree of valve stenosis at rest may not reflect the true severity of obstruction with exercise. (7,14) Guidelines for management of mitral stenosis are based on a point scale comprised of the mitral valve area, transmitral mean gradient and pulmonary artery systolic pressure (Table 1). (7) Severe mitral stenosis is defined as a mitral valve area <1cm 2 , a transmitral mean pressure gradient >10mmHg or pulmonary artery systolic pressure >50mmHg.…”

Section: Mitral Stenosismentioning

confidence: 99%

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When to use stress echocardiography in the evaluation of patients with valvular heart disease

Nkomo

Pellikka

Enríquez-Sarano

et al. 2017

SAHJ

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Section: Mitral Stenosismentioning

confidence: 99%

Section: Mitral Stenosismentioning

confidence: 99%

When to use stress echocardiography in the evaluation of patients with valvular heart disease

Nkomo

Pellikka

Enríquez-Sarano

et al. 2017

SAHJ

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“…A correlation between MVA and func tional class has been reported [39,40], Others have mantained that all patients with an MVA equal to or less than 1 cm2 are symtomatic [41], Harris et al [38] found a signifi cantly different max VO2 in MS patients with MVA greater or less than 1 cm2. Our results were found to be in agreement with these pre vious reports and show a significant although small correlation between MVA and dura tion of exertion.…”

Section: Exercise Performance and Severity O F Msmentioning

confidence: 98%

Treadmill Stress Testing in the Evaluation of Patients with Valvular Heart Disease

Almendral¹,

García-Andoain²,

Sanchezcascos³

et al. 1982

Cardiology

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A series of 123 patients with valvular heart disease underwent treadmill stress testing (Bruce’s protocol). Neither mortality nor serious complications were observed. The incidence of exercise-induced ventricular ectopy was 35% and that of complex ventricular ectopy 19 %. Patients with pure left ventricular volume overload had a significantly higher incidence of exercise-induced ventricular ectopy than did patients with other valvular diseases. A significant relation was found between functional class (NYHA) and either duration of exertion or functional aerobic impairment. The NYHA classification was found to coincide in 62% of the instances with another based on the results obtained from stress testing. In patients with mitral stenosis a significant although slight correlation was found to exist between mitral valve area and duration of exercise. The inability to reach stage III of Bruce’s protocol was associated with a critical mitral stenosis. A hypotensive response to exercise was frequent both in mitral stenosis and aortic stenosis. But whereas in aortic stenosis it was characteristic of the most severe lesions, in mitral stenosis it bore no relation whatsoever to severity. Thus, treadmill stress testing in valvular heart disease is safe, can be helpful in quantifying functional disability and may provide a clue as to the severity of the lesion in specific subsets.

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“…The diastolic transmitral gradient correlates inversely with the mitral valve area and the diastolic filling period. Patients with a mitral valve area <1.5 cm 2 and those with increased heart rates with a decreased diastolic filling period are most likely to have symptoms [32]. Once limiting symptoms occur, 10-year survival ranges from 0% to 15% without intervention [11].…”

Section: Mitral Stenosismentioning

confidence: 99%

Valvular Heart Disease in Aging Women

Petersen

Limacher

2011

Curr Cardiovasc Risk Rep

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Elderly women are at risk for aortic and mitral valve disease that may be challenging to manage because of co-morbidities. Many reports focus on the evaluation and management of elderly patients, but only limited information that is directed specifically at women is available. Until more research can be completed, current guidelines offer updated recommendations for the diagnosis and treatment of significant valvular lesions. On-line and point-based risk assessment instruments are valuable tools for guiding treatment decisions in individual patients.

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The spectrum of pure mitral stenosis

Cited by 128 publications

References 30 publications

When to use stress echocardiography in the evaluation of patients with valvular heart disease

When to use stress echocardiography in the evaluation of patients with valvular heart disease

Treadmill Stress Testing in the Evaluation of Patients with Valvular Heart Disease

Valvular Heart Disease in Aging Women

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