Mitral Stenosis II: Clinical features and Diagnostic Tests

As mitral stenosis progresses, patients typically experience exertional dyspnea, which can worsen to dyspnea at rest. Additional symptoms may include fatigue, palpitations, orthopnea, recurrent respiratory infections, hoarseness, and hemoptysis.

During a cardiac examination, the patient is positioned in the left lateral decubitus position, allowing the healthcare provider to auscultate the heart. A distinctive, low-pitched, rumbling sound is best heard during diastole at the heart's apex.

Diagnostic tests include echocardiography, which assesses the severity of mitral valve stenosis by measuring the mitral valve area and the pressure gradient across the valve.

Electrocardiography may reveal P mitrale, indicated by broad, notched P waves in the lead II, which suggest left atrial enlargement and potential atrial fibrillation.

Chest X-rays help reveal pulmonary congestion, left atrial enlargement, and pulmonary artery enlargement.

Finally, cardiac catheterization detects pressure changes within the heart chambers, records pressure differences across the valves, and measures valve opening sizes.