Mitral stenosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Complications of mitral stenosis are left and right heart failure, endocarditis and embolization.

Natural history

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. In some areas of the developing world, the rate of progression is more rapid due to repeated infections, poorer treatment of the infections, or more virulent infections and the patient may be symptomatic as early as the late teens.

Complications

Complications of mitral stenosis are left and right heart failure, endocarditis and embolization.[1]

Prognosis

Death from mitral stenosis is due to the progressive increase in pulmonary capillary wedge pressure, pulmonary artery pressure and subsequent right-sided heart failure. This porgression of disease occurs in 60 percent of mitral stenosis cases that are not treated [2][3].

Other minor causes of death include[4]:

References

  1. 1.0 1.1 Selzer A, Cohn KE (1972). "Natural history of mitral stenosis: a review". Circulation. 45 (4): 878–90. PMID 4552598.
  2. 2.0 2.1 ROWE JC, BLAND EF, SPRAGUE HB, WHITE PD (1960). "The course of mitral stenosis without surgery: ten- and twenty-year perspectives". Ann Intern Med. 52: 741–9. PMID 14439687.
  3. OLESEN KH (1962). "The natural history of 271 patients with mitral stenosis under medical treatment". Br Heart J. 24: 349–57. PMC 1017892. PMID 14481743.
  4. Abernathy WS, Willis PW (1973). "Thromboembolic complications of rheumatic heart disease". Cardiovasc Clin. 5 (2): 131–75. PMID 4780192.

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