Materiały źródłowe

• #1 Mitral Stenosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/155724-overview

  Mitral stenosis (MS) is characterized by obstruction to left ventricular inflow at the level of mitral valve due to structural abnormality of the mitral valve apparatus. The most common cause of mitral stenosis is rheumatic fever. […] Patients will not experience valve-related symptoms until the valve area is 2-2.5 cm2 or less, at which point moderate exercise or tachycardia may result in exertional dyspnea from the increased transmitral gradient and left atrial pressure. […] Severe mitral stenosis occurs with a valve area of less than 1 cm2. As the valve progressively narrows, the resting diastolic mitral valve gradient, and hence left atrial pressure, increases. This leads to transudation of fluid into the lung interstitium and dyspnea at rest or with minimal exertion. […] Mitral stenosis is a progressive disease consisting of a slow, stable course in the early years followed by an accelerated course later in life. Typically, there is a latent period of 20-40 years from the occurrence of rheumatic fever to the onset of symptoms. Once symptoms develop, it is almost a decade before they become disabling. […] In the asymptomatic or minimally symptomatic patient, survival is greater than 80% at 10 years. When limiting symptoms occur, 10-year survival is less than 15% in the patient with untreated mitral stenosis. When severe pulmonary hypertension develops, mean survival is less than 3 years.

• #2 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral stenosis presents 20 to 40 years after an episode of rheumatic fever. The most common symptoms are orthopnea and paroxysmal nocturnal dyspnea. Patients may have symptoms of palpitations, chest pain, hemoptysis, thromboembolism when the left atrial volume is increased, ascites, edema, and hepatomegaly (if right-side heart failure develops). […] Mitral stenosis progresses slowly from initial signs of mitral stenosis to NYHA functional class II symptoms to atrial fibrillation to NYHA functional class III or IV symptoms. […] Once symptoms become apparent, the progression of the disease generally accelerates, particularly when it is secondary to rheumatic fever. Approximately 80% of patients will not survive ten years from symptomatic onset. In patients with pulmonary hypertension secondary to mitral valve stenosis, survival is around three years. Heart failure often accompanies advanced cases.

• #3 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  Mitral valve stenosis can make you tired and short of breath. Other symptoms may include irregular heartbeats, dizziness, chest pain or coughing up blood. Some people don’t notice symptoms. […] Mitral valve stenosis usually worsens slowly. You may not have any symptoms, or you may have mild ones for many years. Symptoms of mitral valve stenosis can occur at any age, even during childhood. […] Symptoms of mitral valve stenosis include: Shortness of breath, especially with activity or when you lie down. Fatigue, especially during increased activity. Swollen feet or legs. Pounding, skipping or otherwise irregular heartbeats, called arrhythmias. Dizziness or fainting. Fluid buildup in the lungs. Chest discomfort or chest pain. Coughing up blood. […] Mitral valve stenosis symptoms may appear or get worse when the heart rate increases, such as during exercise. Anything that puts stress on the body, including pregnancy or infections, may trigger symptoms. […] Untreated, mitral valve stenosis can lead to serious heart complications.

• #4 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  Mitral valve stenosis (sometimes called mitral stenosis) is a narrowing or blockage of the mitral valve inside your heart. Over time, this condition can cause heart rhythm problems and a higher risk of stroke. It may lead to heart failure and death. […] The most common mitral valve stenosis symptoms are: Shortness of breath. This is the most common symptom. It usually happens during physical activity and exercise but can also happen while lying down. Fatigue. More than being tired, this describes when you feel exhausted to the point that it interferes with your normal activities. Heart palpitations (where you become unpleasantly aware of your own heartbeat). This often happens when mitral valve stenosis puts more pressure on the upper left chamber of your heart, causing an irregular heart rhythm called atrial fibrillation. Stroke. When your heart isn’t pumping blood in its upper chambers as effectively, a clot can form because of the reduced blood flow. This clot can then travel from your heart to your brain, where it can get into a smaller blood vessel and cause a stroke.

• #5 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  Mitral valve stenosis (sometimes called mitral stenosis) is a narrowing or blockage of the mitral valve inside your heart. Over time, this condition can cause heart rhythm problems and a higher risk of stroke. It may lead to heart failure and death. […] The most common mitral valve stenosis symptoms are: Shortness of breath. This is the most common symptom. It usually happens during physical activity and exercise but can also happen while lying down. Fatigue. More than being tired, this describes when you feel exhausted to the point that it interferes with your normal activities. Heart palpitations (where you become unpleasantly aware of your own heartbeat). This often happens when mitral valve stenosis puts more pressure on the upper left chamber of your heart, causing an irregular heart rhythm called atrial fibrillation. Stroke. When your heart isn’t pumping blood in its upper chambers as effectively, a clot can form because of the reduced blood flow. This clot can then travel from your heart to your brain, where it can get into a smaller blood vessel and cause a stroke.

• #6 Mitral Valve Stenosis | The Children’s Hospital at Montefiore

  https://www.cham.org/health-library/article?id=ue1003

  Mitral valve stenosis symptoms may not happen for many years. When symptoms first appear, they usually are mild. […] An early symptom is shortness of breath when you’re active. This shortness of breath may seem normal to you. […] Symptoms later in the disease may include: Shortness of breath even when you haven’t been very active or when you are resting. […] Feeling very tired or weak. […] Mitral valve stenosis is a heart condition in which the mitral valve fails to open as wide as it should. When this happens, not as much blood can flow from the left atrium to the left ventricle. Over time, mitral valve stenosis can cause the left atrium to work harder to pump blood through the narrowed valve. […] Mitral valve stenosis can lead to heart failure and complications such as heart rhythm problems (like atrial fibrillation), fluid buildup in the lungs, and stroke.

• #7 Heart Valve Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease

  Many people with heart valve disease dont have symptoms. But when the condition worsens over time, your heart beats harder to make up for the reduced blood flow. […] Heart valve disease symptoms may include: Fatigue (This may be your first symptom.) Increasing shortness of breath, especially with physical activity Palpitations (skipped beats or a flip-flop feeling in your chest) Edema (swelling of your ankles, feet or abdomen) Weakness or dizziness Quick weight gain Chest pain, especially when you exert yourself. […] If you have heart valve disease, youll have it for your whole life. But your experience of heart valve disease depends on the valve affected and the severity of the problem. […] Some people may have valve disease and never experience any symptoms. Others may have many symptoms and need a valve repair or replacement. Even if your healthcare provider repairs or replaces your valve, youll still need to take medicine and possibly have another replacement in 10 or 15 years. […] Its important to follow up regularly with a healthcare provider to monitor the progression of your valve disease over time.

• #8 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  Mitral valve stenosis can make you tired and short of breath. Other symptoms may include irregular heartbeats, dizziness, chest pain or coughing up blood. Some people don’t notice symptoms. […] Mitral valve stenosis usually worsens slowly. You may not have any symptoms, or you may have mild ones for many years. Symptoms of mitral valve stenosis can occur at any age, even during childhood. […] Symptoms of mitral valve stenosis include: Shortness of breath, especially with activity or when you lie down. Fatigue, especially during increased activity. Swollen feet or legs. Pounding, skipping or otherwise irregular heartbeats, called arrhythmias. Dizziness or fainting. Fluid buildup in the lungs. Chest discomfort or chest pain. Coughing up blood. […] Mitral valve stenosis symptoms may appear or get worse when the heart rate increases, such as during exercise. Anything that puts stress on the body, including pregnancy or infections, may trigger symptoms. […] Untreated, mitral valve stenosis can lead to serious heart complications.

• #9 Mitral Stenosis Signs & Symptoms | Rush

  https://www.rush.edu/conditions/mitral-stenosis

  Mitral stenosis also called mitral valve stenosis is a heart condition where the valve controlling the flow of blood from the upper chamber to the lower chamber on the left side of your heart is blocked. […] Symptoms of mitral stenosis include the following: Shortness of breath (dyspnea), especially during or after exercise or while lying down […] Waking up at night coughing or having trouble breathing […] Heart palpitations (irregular, pounding or skipped heartbeats) […] Fatigue […] Coughing, possibly with blood in the mucous that is coughed up […] Swollen ankles or feet […] Chest pain or discomfort. […] Though people of all ages may experience symptoms of mitral stenosis, most people begin noticing symptoms between the ages of 20 and 50. […] You may have been diagnosed with mitral stenosis many years ago, and you may not have experienced any symptoms. Then, symptoms may come on suddenly. Symptoms can also emerge when the body is stressed, such as during pregnancy or when you have an infection.

• #10 Mitral Valve Stenosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/mitral-stenosis

  Mitral valve stenosis commonly leads to shortness of breath, especially during exercise or when lying down. […] Other common symptoms include: a cough, with or without blood, chest pain, fatigue, swelling in the ankles or feet, respiratory infections, pinkish or purplish cheeks. […] If mitral valve stenosis is severe, you may feel your heart fluttering or beating rapidly. […] In some cases, mitral valve stenosis may not cause any symptoms, or the symptoms may appear only during exercise. […] In addition to the common symptoms, children with mitral valve stenosis might also experience slower growth. […] Mitral valve stenosis can lead to a variety of issues, including fatigue, difficulty breathing, blood clots, and heart failure.

• #11 Mitral Stenosis – Heart and Blood Vessel Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-valve-disorders/mitral-stenosis

  Mitral stenosis does not cause symptoms unless it is severe. […] Mild mitral stenosis does not usually cause symptoms. Eventually the disorder progresses, and people develop symptoms such as shortness of breath and becoming easily tired. […] Once symptoms start, people become severely disabled in about 7 to 9 years. Shortness of breath may then occur even during rest. […] If mitral stenosis is severe, pressure increases in the blood vessels of the lungs (pulmonary hypertension), resulting in heart failure with fluid accumulation in the lungs and a low level of oxygen in the blood. […] People may cough up blood (hemoptysis) if the high pressure causes a vein or capillaries in the lungs to burst. The resulting bleeding into the lungs is usually slight, but if hemoptysis occurs, the person should be evaluated by a doctor promptly because hemoptysis indicates severe mitral stenosis or another serious problem. […] The rate of progression of mitral stenosis varies, but most people develop severe disability about 7 to 9 years after symptoms begin.

• #12 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  Mitral valve stenosis can make you tired and short of breath. Other symptoms may include irregular heartbeats, dizziness, chest pain or coughing up blood. Some people don’t notice symptoms. […] Mitral valve stenosis usually worsens slowly. You may not have any symptoms, or you may have mild ones for many years. Symptoms of mitral valve stenosis can occur at any age, even during childhood. […] Symptoms of mitral valve stenosis include: Shortness of breath, especially with activity or when you lie down. Fatigue, especially during increased activity. Swollen feet or legs. Pounding, skipping or otherwise irregular heartbeats, called arrhythmias. Dizziness or fainting. Fluid buildup in the lungs. Chest discomfort or chest pain. Coughing up blood. […] Mitral valve stenosis symptoms may appear or get worse when the heart rate increases, such as during exercise. Anything that puts stress on the body, including pregnancy or infections, may trigger symptoms. […] Untreated, mitral valve stenosis can lead to serious heart complications.

• #13 Problem: Mitral Valve Stenosis | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/heart-valve-problems-and-causes/problem-mitral-valve-stenosis

  Mitral stenosis causes reduced blood flow through the narrowed valve opening from the left atrium to the left ventricle. As a result, the volume of blood bringing oxygen from the lungs is reduced. This can make you feel tired and short of breath. The volume and pressure from blood remaining in the left atrium increases, which causes the left atrium to enlarge and fluid to build up in the lungs. […] In more advanced rheumatic mitral valve stenosis, surgical repair or replacement of the mitral valve may be required.

• #14 Mitral valve stenosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/mitral-valve-stenosis/symptoms-causes/syc-20353159

  Mitral valve stenosis can make you tired and short of breath. Other symptoms may include irregular heartbeats, dizziness, chest pain or coughing up blood. Some people don’t notice symptoms. […] Mitral valve stenosis usually worsens slowly. You may not have any symptoms, or you may have mild ones for many years. Symptoms of mitral valve stenosis can occur at any age, even during childhood. […] Symptoms of mitral valve stenosis include: Shortness of breath, especially with activity or when you lie down. Fatigue, especially during increased activity. Swollen feet or legs. Pounding, skipping or otherwise irregular heartbeats, called arrhythmias. Dizziness or fainting. Fluid buildup in the lungs. Chest discomfort or chest pain. Coughing up blood. […] Mitral valve stenosis symptoms may appear or get worse when the heart rate increases, such as during exercise. Anything that puts stress on the body, including pregnancy or infections, may trigger symptoms. […] Untreated, mitral valve stenosis can lead to serious heart complications.

• #15 Mitral Valve Stenosis Causes, Symptoms, and Treatment

  https://www.upmc.com/services/heart-vascular/conditions/mitral-valve-stenosis

  Mitral valve stenosis prevents your mitral valve from opening properly, in some cases by causing the two flaps to partially fuse together. This prevents some of the blood from moving out of the atrium. […] Many people with mitral valve stenosis have no symptoms at all. When symptoms do occur, they usually begin gradually in people in their 30s or 40s, though they can occur at any age. […] Symptoms of mitral valve stenosis can appear suddenly and worsen when your heart rate rises during exercise or physical exertion. Pregnancy and infection can also bring on symptoms. Telltale signs include heart murmur and irregular heart rhythms, or arrhythmias. […] Some people with the condition may have mild symptoms that worsen over time, including: coughing, sometimes with blood; fatigue, especially when exercising; frequent lung infections, such as bronchitis; heart palpitations, which is the sensation of feeling your own heartbeat; shortness of breath during mild exertion, at rest, or when you lie down; swollen feet or ankles (edema). […] Early diagnosis and treatment of mitral valve stenosis can improve your long-term outcomes and survival rate.

• #16 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/symptoms

  Early mitral stenosis is often asymptomatic, until the mitral valve area decreases enough to require large increases in pulmonary and left atrial pressure to maintain cardiac output with activity. […] Advanced symptoms include fatigue, exercise intolerance, and, with the onset of right heart failure, paroxysmal nocturnal dyspnea and orthopnea. Symptoms of mitral stenosis are exacerbated by concomitant conditions that increase cardiac output, such as anemia, thyrotoxicosis and pregnancy. […] Patients with moderate to severe mitral stenosis will have some degree of left atrial enlargement (LAE) due to the chronically increased left atrial pressures; this increases the likelihood of atrial fibrillation. […] With mitral stenosis, atrial contraction contributes about 20% of LV filling, and tachycardia decreases diastolic filling time. Therefore, the onset of atrial fibrillation with a rapid ventricular rate and loss of atrial contraction may result in significant reduction of cardiac output with fatigue, dyspnea, dizziness, and even syncope.

• #17 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Signs and symptoms of mitral stenosis include the following: […] Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND) […] Fatigue and weakness increase with exercise and pregnancy. […] The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 4.3 years. […] Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class II symptoms to the development of atrial fibrillation to the development of NYHA functional class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient’s condition deteriorates.

• #18 Mitral Valve Stenosis: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/mitral-valve-stenosis/treatment

  Mitral valve stenosis happens when the opening between the two left chambers of the heart becomes too narrow. This slows down the blood flow through the heart. In the early or mild stages, you may not have symptoms (asymptomatic). If you are diagnosed with mitral stenosis, it’s important to be monitored by a specialist and eventually get treatment. Depending on the severity of your case, your doctor may treat your symptoms with medication or recommend surgery to repair or replace the valve. […] If you have symptoms of mitral valve stenosis, you should speak with a doctor as soon as possible. Mild cases of the condition are usually asymptomatic, so having symptoms is a sign that the disease has already progressed. […] Stage C (severe asymptomatic): The valve is more significantly narrowed, but you still dont have symptoms. […] Stage D (severe symptomatic): In the most severe stage, the valve is very narrow, and you experience noticeable symptoms.

• #19 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Signs and symptoms of mitral stenosis include the following: […] Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND) […] Fatigue and weakness increase with exercise and pregnancy. […] The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 4.3 years. […] Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class II symptoms to the development of atrial fibrillation to the development of NYHA functional class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient’s condition deteriorates.

• #20 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral stenosis presents 20 to 40 years after an episode of rheumatic fever. The most common symptoms are orthopnea and paroxysmal nocturnal dyspnea. Patients may have symptoms of palpitations, chest pain, hemoptysis, thromboembolism when the left atrial volume is increased, ascites, edema, and hepatomegaly (if right-side heart failure develops). […] Mitral stenosis progresses slowly from initial signs of mitral stenosis to NYHA functional class II symptoms to atrial fibrillation to NYHA functional class III or IV symptoms. […] Once symptoms become apparent, the progression of the disease generally accelerates, particularly when it is secondary to rheumatic fever. Approximately 80% of patients will not survive ten years from symptomatic onset. In patients with pulmonary hypertension secondary to mitral valve stenosis, survival is around three years. Heart failure often accompanies advanced cases.

• #21 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Signs and symptoms of mitral stenosis include the following: […] Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND) […] Fatigue and weakness increase with exercise and pregnancy. […] The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 4.3 years. […] Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class II symptoms to the development of atrial fibrillation to the development of NYHA functional class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient’s condition deteriorates.

• #22 Mitral Stenosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/155724-overview

  Mitral stenosis (MS) is characterized by obstruction to left ventricular inflow at the level of mitral valve due to structural abnormality of the mitral valve apparatus. The most common cause of mitral stenosis is rheumatic fever. […] Patients will not experience valve-related symptoms until the valve area is 2-2.5 cm2 or less, at which point moderate exercise or tachycardia may result in exertional dyspnea from the increased transmitral gradient and left atrial pressure. […] Severe mitral stenosis occurs with a valve area of less than 1 cm2. As the valve progressively narrows, the resting diastolic mitral valve gradient, and hence left atrial pressure, increases. This leads to transudation of fluid into the lung interstitium and dyspnea at rest or with minimal exertion. […] Mitral stenosis is a progressive disease consisting of a slow, stable course in the early years followed by an accelerated course later in life. Typically, there is a latent period of 20-40 years from the occurrence of rheumatic fever to the onset of symptoms. Once symptoms develop, it is almost a decade before they become disabling. […] In the asymptomatic or minimally symptomatic patient, survival is greater than 80% at 10 years. When limiting symptoms occur, 10-year survival is less than 15% in the patient with untreated mitral stenosis. When severe pulmonary hypertension develops, mean survival is less than 3 years.

• #23 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Signs and symptoms of mitral stenosis include the following: […] Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND) […] Fatigue and weakness increase with exercise and pregnancy. […] The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 4.3 years. […] Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class II symptoms to the development of atrial fibrillation to the development of NYHA functional class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient’s condition deteriorates.

• #24 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral stenosis presents 20 to 40 years after an episode of rheumatic fever. The most common symptoms are orthopnea and paroxysmal nocturnal dyspnea. Patients may have symptoms of palpitations, chest pain, hemoptysis, thromboembolism when the left atrial volume is increased, ascites, edema, and hepatomegaly (if right-side heart failure develops). […] Mitral stenosis progresses slowly from initial signs of mitral stenosis to NYHA functional class II symptoms to atrial fibrillation to NYHA functional class III or IV symptoms. […] Once symptoms become apparent, the progression of the disease generally accelerates, particularly when it is secondary to rheumatic fever. Approximately 80% of patients will not survive ten years from symptomatic onset. In patients with pulmonary hypertension secondary to mitral valve stenosis, survival is around three years. Heart failure often accompanies advanced cases.

• #25 Mitral Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/mitral-stenosis/symptoms

  In the absence of atrial fibrillation, patients with mitral stenosis still have an increased risk for thrombus formation in their left atrial appendage due to stasis. This may lead to thromboembolic events including stroke, coronary embolism with myocardial infarction, acute mesenteric ischemia or acute digital ischemia (blue toe syndrome). […] Less common today are symptoms of advanced valve disease. Hemoptysis may occur due to sudden rupture of a bronchial vein; this phenomenon is termed pulmonary apoplexy. Ortners syndrome may occur when a greatly enlarged left atrium compresses the left recurrent laryngeal nerve, leading to hoarseness. Chest pain from right ventricular ischemia may occur with severe pulmonary hypertension. Other signs of right heart failure, such as right upper quadrant pain due to hepatic congestion and peripheral edema, can also occur.

• #26 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral stenosis presents 20 to 40 years after an episode of rheumatic fever. The most common symptoms are orthopnea and paroxysmal nocturnal dyspnea. Patients may have symptoms of palpitations, chest pain, hemoptysis, thromboembolism when the left atrial volume is increased, ascites, edema, and hepatomegaly (if right-side heart failure develops). […] Mitral stenosis progresses slowly from initial signs of mitral stenosis to NYHA functional class II symptoms to atrial fibrillation to NYHA functional class III or IV symptoms. […] Once symptoms become apparent, the progression of the disease generally accelerates, particularly when it is secondary to rheumatic fever. Approximately 80% of patients will not survive ten years from symptomatic onset. In patients with pulmonary hypertension secondary to mitral valve stenosis, survival is around three years. Heart failure often accompanies advanced cases.

• #27 Mitral Valve Stenosis: Symptoms & Causes | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/mitral-valve-stenosis

  Often, mitral stenosis doesn’t cause symptoms until it’s in the severe stages. Those symptoms result from your body not getting enough oxygen-rich blood and from your heart working too hard and from your lungs being too congested. If you don’t get treatment for mitral stenosis, it can lead to severe complications, including heart failure. […] Untreated mitral valve stenosis can interfere with your daily life, but it can also lead to complications, including atrial fibrillation, stroke, and heart failure. […] The first easily detected symptom of mitral stenosis is usually a heart murmur, an abnormal sound when the heart beats. Your doctor may detect a heart murmur during a routine check-up or during a scheduled examination if you suspect a valve problem. The first symptoms you are likely to notice without a doctor are the primary symptoms of mitral stenosis: shortness of breath, fatigue, and heart palpitations.

• #28 Mitral Stenosis – Symptoms and Clinical Assessment – Cardio Blogger

  https://cardioblogger.com/mitral-stenosis-symptoms-and-clinical-assessment/

  Dyspnoea MC symptom due to […] Inability to increase cardiac output with exercise […] Raised LA pressure increased pulmonary venous pressures and reduced pulmonary compliance […] Reduced vital capacity because of engorged pulmonary vessels and interstitial oedema […] Angina 15 % […] Haemoptysis in mitral stenosis […] Other symptoms […] Palpitation/Embolic events […] Ortners syndrome Hoarseness of voice due to compression of recurrent laryngeal nerve by enlarged left atrium, tracheobronchial lymph nodes and enlarged pulmonary artery […] Atrial fibrillation occurs in around 40 % patients with MS. 80 % incidence more than 50 years of age. Left atrial size more than 40 mm 54 % AF […] Systemic embolism overall incidence is 20 %. Also 20 % in patients with sinus rhythm. […] Mortality ranges from 19-22 % […] Infective endocarditis incidence 0.17/1000 per year (less than 1 %). Mortality ranges from 5-8% […] Silent MS […] Mild MS […] Very severe MS and PAH (apex formed by RV) […] Severe calcification and poor subvalvular pathology […] Low flow regardless of cause

• #29 Mitral Stenosis – Symptoms and Clinical Assessment – Cardio Blogger

  https://cardioblogger.com/mitral-stenosis-symptoms-and-clinical-assessment/

  Dyspnoea MC symptom due to […] Inability to increase cardiac output with exercise […] Raised LA pressure increased pulmonary venous pressures and reduced pulmonary compliance […] Reduced vital capacity because of engorged pulmonary vessels and interstitial oedema […] Angina 15 % […] Haemoptysis in mitral stenosis […] Other symptoms […] Palpitation/Embolic events […] Ortners syndrome Hoarseness of voice due to compression of recurrent laryngeal nerve by enlarged left atrium, tracheobronchial lymph nodes and enlarged pulmonary artery […] Atrial fibrillation occurs in around 40 % patients with MS. 80 % incidence more than 50 years of age. Left atrial size more than 40 mm 54 % AF […] Systemic embolism overall incidence is 20 %. Also 20 % in patients with sinus rhythm. […] Mortality ranges from 19-22 % […] Infective endocarditis incidence 0.17/1000 per year (less than 1 %). Mortality ranges from 5-8% […] Silent MS […] Mild MS […] Very severe MS and PAH (apex formed by RV) […] Severe calcification and poor subvalvular pathology […] Low flow regardless of cause

• #30 Mitral Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430742/

  Mitral stenosis presents 20 to 40 years after an episode of rheumatic fever. The most common symptoms are orthopnea and paroxysmal nocturnal dyspnea. Patients may have symptoms of palpitations, chest pain, hemoptysis, thromboembolism when the left atrial volume is increased, ascites, edema, and hepatomegaly (if right-side heart failure develops). […] Mitral stenosis progresses slowly from initial signs of mitral stenosis to NYHA functional class II symptoms to atrial fibrillation to NYHA functional class III or IV symptoms. […] Once symptoms become apparent, the progression of the disease generally accelerates, particularly when it is secondary to rheumatic fever. Approximately 80% of patients will not survive ten years from symptomatic onset. In patients with pulmonary hypertension secondary to mitral valve stenosis, survival is around three years. Heart failure often accompanies advanced cases.

• #31 Mitral Stenosis: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/155724-overview

  Mitral stenosis (MS) is characterized by obstruction to left ventricular inflow at the level of mitral valve due to structural abnormality of the mitral valve apparatus. The most common cause of mitral stenosis is rheumatic fever. […] Patients will not experience valve-related symptoms until the valve area is 2-2.5 cm2 or less, at which point moderate exercise or tachycardia may result in exertional dyspnea from the increased transmitral gradient and left atrial pressure. […] Severe mitral stenosis occurs with a valve area of less than 1 cm2. As the valve progressively narrows, the resting diastolic mitral valve gradient, and hence left atrial pressure, increases. This leads to transudation of fluid into the lung interstitium and dyspnea at rest or with minimal exertion. […] Mitral stenosis is a progressive disease consisting of a slow, stable course in the early years followed by an accelerated course later in life. Typically, there is a latent period of 20-40 years from the occurrence of rheumatic fever to the onset of symptoms. Once symptoms develop, it is almost a decade before they become disabling. […] In the asymptomatic or minimally symptomatic patient, survival is greater than 80% at 10 years. When limiting symptoms occur, 10-year survival is less than 15% in the patient with untreated mitral stenosis. When severe pulmonary hypertension develops, mean survival is less than 3 years.

• #32 Mitral Valve Stenosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/mitral-valve-stenosis

  Many children with mitral valve stenosis show no outward signs, since they are in the mild to moderate stages of the condition and their symptoms have not yet progressed to a more serious level. The only identifiable symptoms, in most cases, are rapid breathing, slow growth/weight gain or a soft heart murmur. […] As mitral valve stenosis progresses, children may show more symptoms: Rapid or labored breathing, Frequent coughing or wheezing, Slow growth/weight gain, Feeding difficulties, Fatigue, Frequent respiratory infections, Irregular heartbeats or heart palpitations, Chest pain, Difficulty exercising. […] You should seek treatment from a qualified medical professional right away if you notice any of these warning signs in your child.

• #33 Mitral valve stenosis in children – Children’s Health Cardiology

  https://www.childrens.com/specialties-services/conditions/mitral-stenosis

  Mitral valve stenosis is a defect in the valve it may be fused, too thick or have another structural problem. […] Sometimes, children are born with mitral valve stenosis. This heart defect can make the heart work harder to pump blood and cause your child’s heart to weaken over time. […] What are the signs and symptoms of mitral valve stenosis in children? Rapid or labored breathing, coughing or wheezing, slow growth and slow weight gain, feeding difficulties, fatigue, respiratory infections, irregular heartbeats, chest pain, difficulty exercising, a heart murmur found by their doctor on exam. […] Children with more serious mitral valve stenosis may need surgery. However, some will not need any immediate treatment. Many children with mitral valve stenosis live healthy lives with regular checkups by their care team. […] For the most part, children with mitral valve stenosis live very healthy, productive lives. However, some children may experience some limitations on their physical activity. It all depends on the child and their overall health.

• #34 Mitral stenosis: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000175.htm

  Symptoms may include: […] Difficulty breathing during or after exercise (This is the most common symptom.) […] In infants and children, symptoms may be present from birth (congenital). They will almost always develop within the first 2 years of life. Symptoms include: […] Shortness of breath. […] The outcome varies. The disorder may be mild, without symptoms, or may be more severe and become disabling over time. Complications may be severe or life threatening. In most cases, mitral stenosis can be controlled with treatment and improved with valvuloplasty or surgery.

• #35 Heart valve disease

  https://www.nhs.uk/conditions/heart-valve-disease/

  Symptoms of heart valve disease can include: shortness of breath, feeling tired or weak, feeling dizzy, heart palpitations, where you suddenly feel your heart beating irregularly or faster than usual, swollen ankles and feet, chest pain or discomfort. […] Some people do not have any symptoms. Sometimes it’s found by chance if a doctor hears an unusual sound (a heart murmur) when they listen to your chest. […] If you have symptoms or have severe heart valve disease, you may need medicines to: lower your blood pressure and help protect your heart (ACE inhibitors), reduce build-up of fluid in your body and lungs (diuretics), slow down your heart rate (such as beta blockers), reduce the risk of blood clots (anticoagulants). […] If you have severe heart valve disease you’ll usually need surgery to either: repair the heart valve, if it’s not seriously damaged, replace the heart valve with an artificial valve or one made from human or animal tissue, if it cannot be repaired. […] It’s important to get advice from a heart specialist if you’re pregnant or want to get pregnant. Pregnancy can make heart valve disease symptoms worse.

• #36 Mitral stenosis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/mitral-stenosis

  Mitral stenosis is a disorder in which the mitral valve does not fully open. This restricts the flow of blood. […] Symptoms may begin with an episode of atrial fibrillation (especially if it causes a fast heart rate). Symptoms may also be triggered by pregnancy or other stress on the body, such as infection in the heart or lungs, or other heart disorders. […] Adults may have no symptoms. However, symptoms may appear or get worse with exercise or other activity that raises the heart rate. Symptoms will most often develop between ages 20 and 50. […] Symptoms may include: […] Difficulty breathing during or after exercise (This is the most common symptom.) […] In infants and children, symptoms may be present from birth (congenital). They will almost always develop within the first 2 years of life. Symptoms include:

• #37 Heart valve disease

  https://www.nhs.uk/conditions/heart-valve-disease/

  Symptoms of heart valve disease can include: shortness of breath, feeling tired or weak, feeling dizzy, heart palpitations, where you suddenly feel your heart beating irregularly or faster than usual, swollen ankles and feet, chest pain or discomfort. […] Some people do not have any symptoms. Sometimes it’s found by chance if a doctor hears an unusual sound (a heart murmur) when they listen to your chest. […] If you have symptoms or have severe heart valve disease, you may need medicines to: lower your blood pressure and help protect your heart (ACE inhibitors), reduce build-up of fluid in your body and lungs (diuretics), slow down your heart rate (such as beta blockers), reduce the risk of blood clots (anticoagulants). […] If you have severe heart valve disease you’ll usually need surgery to either: repair the heart valve, if it’s not seriously damaged, replace the heart valve with an artificial valve or one made from human or animal tissue, if it cannot be repaired. […] It’s important to get advice from a heart specialist if you’re pregnant or want to get pregnant. Pregnancy can make heart valve disease symptoms worse.

• #38 Mitral Valve Stenosis: Symptoms & Causes | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/mitral-valve-stenosis

  Mitral valve stenosis occurs when the opening between the two left chambers of the heart is too narrow, becomes blocked, or can’t open completely. When that happens, blood can’t flow through the heart normally. The reduced blood flow causes a buildup of pressure in the heart and causes backup of blood in the lungs and makes it hard to send blood to the rest of the body’s tissues. […] The most common symptom of mitral stenosis is shortness of breath, either during exercise or when lying down. Other common symptoms include: Fluid in the lungs, causing trouble breathing, Swelling in the ankles and feet, Fatigue, Lack of stamina, Coughing up blood, Fainting, Heart murmur, Heart palpitations (a feeling of racing or fluttering heartbeat), Irregular heartbeat (atrial fibrillation). […] It’s possible for the mitral valve to narrow slightly but still allow enough blood flow for normal function, so mild mitral stenosis may not have any noticeable symptoms. If you have symptoms of mitral valve stenosis, your condition may have already progressed to more severe stages.

• #39 Rheumatic mitral stenosis: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/rheumatic-mitral-stenosis-clinical-manifestations-and-diagnosis

  Symptoms — The duration of the asymptomatic phase of rheumatic MS (or mixed MS and mitral regurgitation) varies widely, with generally more rapid progression in resource-limited countries, and slower progression to symptoms in resource-abundant countries. […] MS usually presents with exertional dyspnea and/or decreased exercise tolerance. These symptoms are primarily related to the severity of the valvular stenosis, as it impacts the left atrial pressure, pulmonary pressures, pulmonary vascular resistance, and cardiac output. However, many patients with severe MS do not recognize symptoms because slow progression of disease is accompanied by a gradual reduction in activity and generalized deconditioning. As a result, a careful history regarding exercise tolerance is often required to document a slow decline in functional status.

• #40 Rheumatic mitral stenosis: Clinical manifestations and diagnosis – UpToDate

  https://www.uptodate.com/contents/rheumatic-mitral-stenosis-clinical-manifestations-and-diagnosis

  Symptoms — The duration of the asymptomatic phase of rheumatic MS (or mixed MS and mitral regurgitation) varies widely, with generally more rapid progression in resource-limited countries, and slower progression to symptoms in resource-abundant countries. […] MS usually presents with exertional dyspnea and/or decreased exercise tolerance. These symptoms are primarily related to the severity of the valvular stenosis, as it impacts the left atrial pressure, pulmonary pressures, pulmonary vascular resistance, and cardiac output. However, many patients with severe MS do not recognize symptoms because slow progression of disease is accompanied by a gradual reduction in activity and generalized deconditioning. As a result, a careful history regarding exercise tolerance is often required to document a slow decline in functional status.

• #41 Mitral Valve Stenosis: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/mitral-valve-stenosis/treatment

  Mitral valve stenosis happens when the opening between the two left chambers of the heart becomes too narrow. This slows down the blood flow through the heart. In the early or mild stages, you may not have symptoms (asymptomatic). If you are diagnosed with mitral stenosis, it’s important to be monitored by a specialist and eventually get treatment. Depending on the severity of your case, your doctor may treat your symptoms with medication or recommend surgery to repair or replace the valve. […] If you have symptoms of mitral valve stenosis, you should speak with a doctor as soon as possible. Mild cases of the condition are usually asymptomatic, so having symptoms is a sign that the disease has already progressed. […] Stage C (severe asymptomatic): The valve is more significantly narrowed, but you still dont have symptoms. […] Stage D (severe symptomatic): In the most severe stage, the valve is very narrow, and you experience noticeable symptoms.

• #42 Mitral valve stenosis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/mitral-valve-stenosis/

  Many patients with mild to moderate disease can be managed conservatively for years. Patients should remain under the care of cardiology with regular monitoring of valve function. […] Serial TTEs are performed to monitor the progression of MS and guide the timing of interventions. Patients typically do not develop symptoms until they have severe disease. Early detection prevents irreversible cardiac changes.

• #43 Mitral stenosis – Wikipedia

  https://en.wikipedia.org/wiki/Mitral_stenosis

  Signs and symptoms of mitral stenosis include the following: […] Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND) […] Fatigue and weakness increase with exercise and pregnancy. […] The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 4.3 years. […] Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class II symptoms to the development of atrial fibrillation to the development of NYHA functional class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient’s condition deteriorates.

• #44 Heart Valve Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease

  Many people with heart valve disease dont have symptoms. But when the condition worsens over time, your heart beats harder to make up for the reduced blood flow. […] Heart valve disease symptoms may include: Fatigue (This may be your first symptom.) Increasing shortness of breath, especially with physical activity Palpitations (skipped beats or a flip-flop feeling in your chest) Edema (swelling of your ankles, feet or abdomen) Weakness or dizziness Quick weight gain Chest pain, especially when you exert yourself. […] If you have heart valve disease, youll have it for your whole life. But your experience of heart valve disease depends on the valve affected and the severity of the problem. […] Some people may have valve disease and never experience any symptoms. Others may have many symptoms and need a valve repair or replacement. Even if your healthcare provider repairs or replaces your valve, youll still need to take medicine and possibly have another replacement in 10 or 15 years. […] Its important to follow up regularly with a healthcare provider to monitor the progression of your valve disease over time.

• #45 Mitral valve stenosis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/mitral-valve-stenosis

  Mitral valve stenosis can make you tired and short of breath. Other symptoms may include irregular heartbeats, dizziness, chest pain or coughing up blood. Some people don’t notice symptoms. […] Mitral valve stenosis usually worsens slowly. You may not have any symptoms, or you may have mild ones for many years. Symptoms of mitral valve stenosis can occur at any age, even during childhood. […] Symptoms of mitral valve stenosis include: Shortness of breath, especially with activity or when you lie down. Fatigue, especially during increased activity. Swollen feet or legs. Pounding, skipping or otherwise irregular heartbeats, called arrhythmias. Dizziness or fainting. Fluid buildup in the lungs. Chest discomfort or chest pain. Coughing up blood. […] Mitral valve stenosis symptoms may appear or get worse when the heart rate increases, such as during exercise. Anything that puts stress on the body, including pregnancy or infections, may trigger symptoms.

• #46 Mitral Valve Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21903-mitral-valve-stenosis

  It can take years or even decades before mitral valve stenosis symptoms develop, especially when rheumatic fever is the cause. Many people don’t develop mitral valve stenosis for 20 to 40 years after they first had rheumatic fever. Once you develop symptoms, the progression of the disease usually speeds up. Your prognosis depends on how active/functional you are at baseline. People with more severe symptoms like shortness of breath have a worse prognosis than those without. For people who’ve developed high blood pressure in their lungs because of mitral valve stenosis, that survival time is around three years. Heart failure is common in advanced cases. […] The best outcomes from mitral valve stenosis happen with early detection and timely treatment. Because mitral valve stenosis usually causes a heart murmur, your healthcare provider can often catch it when they listen to your heart during an annual physical exam or checkup. This can help detect and treat it before it becomes severe or advanced.

• #47 Mitral Valve Stenosis: Symptoms & Causes | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/mitral-valve-stenosis

  Often, mitral stenosis doesn’t cause symptoms until it’s in the severe stages. Those symptoms result from your body not getting enough oxygen-rich blood and from your heart working too hard and from your lungs being too congested. If you don’t get treatment for mitral stenosis, it can lead to severe complications, including heart failure. […] Untreated mitral valve stenosis can interfere with your daily life, but it can also lead to complications, including atrial fibrillation, stroke, and heart failure. […] The first easily detected symptom of mitral stenosis is usually a heart murmur, an abnormal sound when the heart beats. Your doctor may detect a heart murmur during a routine check-up or during a scheduled examination if you suspect a valve problem. The first symptoms you are likely to notice without a doctor are the primary symptoms of mitral stenosis: shortness of breath, fatigue, and heart palpitations.

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