Nerve Blocks App
Anesthesia Assistant App
US Pain Management App
Pain Medicine Assistant App
POCUS App
IV Access App
MSK Knee App
VetRA App
Nerve Block Manual
Regional Anesthesia Updates
Anesthesiology Manual
Anesthesiology Review
Anesthesia Updates 2025
Anesthesia Updates 2026
Pediatric Anesthesia Updates
Airway Management Updates
US Interventional Pain Manual
Pain Medicine Updates
Mastering Difficult IV Access
PACU Nursing Manual
RA Veterinary Manual
Books
About
Learning objectives
- Describe the causes and subsequent pathophysiology of mitral stenosis
- Classify the severity of mitral stenosis
- Anesthetic management of mitral stenosis
Definition & mechanisms
- Mitral stenosis occurs when the mitral valve is narrowed and blood cannot flow normally
- Causes:
| Common | Rheumatic fever |
| Degenerative calcification | |
| Endocarditis | |
| Uncommon | Infiltrating diseases |
| Congenital deformities |
|
| Diseases that affect multiple systems (e.g., sarcoidosis) |
Signs & symptoms
- Patients will remain asymptomatic for many years (compensation due to the compliant left atrium dilating and keeping pulmonary venous pressures stable)
- As the disease progresses, compensation is overcome and pulmonary hypertension develops
- Pulmonary edema and dyspnea
- Fatigue
- More frequent lower respiratory tract infections
- Atrial fibrillation will rapidly progress the pathophysiology
Severity assessment
| Mild | Moderate | Severe | |
|---|---|---|---|
| Mean pressure decrease | <5 mm Hg | 6–10 mm Hg | >10 mm Hg |
| Pressure half-time | <139 ms | 140–219 ms | ≥220 ms |
| Valve area | 1.6–2.0 cm2 | 1.5–1.0 cm2 | <1.0 cm2 |
Management
Suggested reading
- Holmes K, Gibbison B, Vohra HA. Mitral valve and mitral valve disease. BJA Education. 2017;17(1):1-9.
- 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 Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63:e57.
