This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Clinical features of mitral stenosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

There are two main presentations of mitral stenosis:

Patients with a normal pulmonary vascular resistance present principally with dyspnoea and pulmonary oedema, a result of increased left atrial pressure. This presentation is more common in younger patients and is exacerbated by situations of increased blood volume, for example, during pregnancy.

Patients with an increased pulmonary vascular resistance present principally with fatigue, mitral facies, a raised JVP, and right ventricular hypertrophy. This presentation is more common in older patients with a low cardiac output and right heart failure. Dyspnoea is less prominent in this group. When the mitral valve is immobile, these patients frequently present with a diagnosis of cor pulmonale as the opening snap and murmur may not be detected.

In general, features of mitral stenosis on examination include:

  • small pulse, which may be irregularly irregular
  • jugular venous pressure is only raised if there is heart failure
  • right ventricular hypertrophy, tapping apex beat
  • loud S1, loud P2 if pulmonary hypertension
  • opening snap
  • mid-diastolic murmur heard at the apex only
  • pre-systolic accentuation murmur if no atrial fibrillation

The more severe the stenosis, the larger the left atrium, the worse the dyspnoea, the closer the opening snap is to the second heart sound, and the longer the murmur.


Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.