Mitral Stenosis III: Medical Management

Management of mitral stenosis includes prevention, medication management, and surgical interventions.

Prevention focuses on reducing the risk of bacterial infections, like streptococcal pharyngitis, which can lead to rheumatic fever.

Long-term antibiotic prophylaxis is used to prevent recurrent rheumatic fever. It may include Penicillin G administered intramuscularly every four weeks, Penicillin V taken orally twice daily, and Sulfadiazine taken orally daily.

For patients with severe left atrial dilation, anticoagulants such as warfarin may be prescribed to reduce the risk of atrial thrombi.

In cases of atrial fibrillation, cardioversion may restore normal sinus rhythm.

If cardioversion fails, the ventricular rate can be controlled with digoxin or calcium channel blockers.

Patients with severe mitral stenosis should avoid strenuous activities like competitive sports, as they can worsen symptoms.

Surgical interventions include valvuloplasty to separate fused valve leaflets, percutaneous transluminal valvuloplasty to open the narrowed valve, and valve replacement with a prosthetic valve.