PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “MITRAL STENOSIS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1997

Congenital mitral stenosis: challenge of percutaneous transvenous mitral commissurotomy.

A 26-year-old woman with congenital mitral stenosis and embolic stroke was referred to our hospital. The echocardiogram showed a hypoplastic posterior mitral valve leaflet with short, unbalanced chordal attachments to the posteromedial papillary muscle. The mitral valve area was 0.9 cm2 by the pressure half-time method. There was no left atrial thrombus and spontaneous echo contrast. Percutaneous transvenous mitral commissurotomy was performed since the suggestion of surgical management was refused by her family members. A rupture at the chordae tendinae of the hypoplastic posterior papillary muscle developed during the procedure and needed mitral replacement. We advise that percutaneous transvenous mitral commissurotomy be avoided in adult patients with congenital mitral stenosis having an asymmetric and hypoplastic mitral valve.

Adult↗
PubMed1999

Exercise-induced hyperkalemia and concentration of Na,K-pumps in skeletal muscle in mitral stenosis: effect of balloon mitral valvotomy.

BACKGROUND AND AIMS OF THE STUDY: The study aim was to examine the effects of balloon mitral valvotomy (BMV) on exercise-induced hyperkalemia, and on changes in the concentration of Na,K-pumps in skeletal muscle, as an exaggerated exercise-induced rise in potassium concentration ([K+]) may contribute to exertional fatigue and breathlessness. METHODS: Eight subjects were evaluated with mitral stenosis (mean age 34 +/- 5.2 years) before, and at two weeks and four months after BMV. Subjects underwent incremental exercise to exhaustion for exercise-induced rise in [K+] and vastus lateralis biopsy for concentration of Na,K-pumps. RESULTS: Mean (+/- SE) valve area increased from 0.89 +/- 0.03 cm2 before to 1.75 +/- 0.05 cm2 after BMV. There was a progressive increase in VO2,max (15.3 +/- 1.6, 17.2 +/- 1.4 and 19.9 +/- 1.9 l/kg/min) at baseline, early after and later after BMV, respectively (p < 0.01). The rise in [K+] with absolute workload fell progressively at early and late follow up post-BMV (p < 0.05), but was unchanged when plotted against percentage of VO2,max to match for relative workload. The concentration of Na,K-pumps was similar to baseline at early follow up (233 +/- 10 versus 228 +/- 15 pmol/g wet weight), but was significantly increased at late follow up after four months (265 +/- 17 pmol/g; p < 0.05). When the relationship between the concentration of Na,K-pumps and the exercise-induced rise in [K+] was studied, a negative correlation was found. However, correlation analysis for the effects of changes in Na,K-pumps on changes in exercise hyperkalemia after BMV was not significant. CONCLUSIONS: The progressive reduction in exercise-induced rise in [K+] after BMV may contribute to the progressive improvement in exercise performance. The increased concentration of Na,K-pumps in skeletal muscle may assist in this improvement, and emphasizes the importance of peripheral adaptations in clinical improvement after BMV.

Adult↗
PubMed2003

Fibrillatory wave amplitude as a marker of left atrial and left atrial appendage function, and a predictor of thromboembolic risk in patients with rheumatic mitral stenosis.

BACKGROUND: Patients with mitral stenosis, especially those with atrial fibrillation, are at increased risk for thromboembolic complications. Size of the left atrium, left atrial appendage dysfunction and severity of mitral stenosis are known risk factors for thromboembolism in patients with mitral stenosis. It has been postulated that F-wave amplitude on surface ECG is correlated with left atrial size, left atrial appendage function, and risk of thromboembolism in patients with nonrheumatic atrial fibrillation. The aims of this study were as follows: (1) to examine the relationship between surface ECG F-wave amplitude and left atrial appendage function, and (2) to assess the clinical significance of F-wave amplitude as it relates to risk of thromboembolism in a group of patients with rheumatic mitral stenosis. MATERIAL AND METHODS: One hundred patients with rheumatic mitral stenosis and permanent atrial fibrillation but without moderate to severe mitral insufficiency were investigated by transthoracic and transesophageal echocardiography. Two groups were formed according to the presence of a coarse (Group 1; n=60; F-wave in lead V1> or =1 mm) or fine (Group 2; n=40; F-wave in lead V1<1 mm) F-wave on surface ECG. RESULTS: Comparison showed that Group 1 had significantly smaller mitral valve area (1.44+/-0.6 versus 1.7+/-0.74 cm2, respectively; P<0.05), lower peak left atrial appendage flow velocity (18.8+/-2.1 versus 25.6+/-1.9 cm/s, respectively; P<0.005), higher-grade spontaneous echo contrast (2.05+/-1.44 versus 0.98+/-1.14, respectively; P<0.0001), and higher prevalence of thromboembolism (35% versus 12.5%, respectively; P<0.012). Multiple logistic regression analysis revealed that mitral valve area, left atrial appendage peak velocity, and coarse F-wave were independent clinical risk factors for thromboembolism in this patient group. CONCLUSION: The data suggest that presence of a coarse F-wave on surface ECG is associated with left atrial appendage dysfunction, and indicates higher thromboembolic risk in patients with predominant rheumatic mitral stenosis.

Adolescent↗
PubMed1980

[How reliable is echocardiography in evaluating the severity of mitral stenosis].

40 patients with mitral stenosis were examined by M-mode and 2-dimensional echocardiography. E-F slope, mitral valve closure index and mitral valve area were compared with the invasively determined mitral valve area. E-F slope and closure index correlated with the valve area by an r of 0.65 and 0.62 respectively. The mitral valve area as calculated by 2D echocardiogram showed a correlation with the invasively determined valve area of 0.86 and was even better in patients with sinus rhythm (0.91). However, in severe mitral stenosis (less than 1 cm2) this correlation was only 0.62 by estimating 22% of patients with severe mitral stenosis as only moderate (greater than 1 cm2). It is concluded that whereas E-F slope and closure index are not of use in the quantification mitral stenosis, determination of mitral valve areas by 2D echo is reliable. However, in the severe mitral stenosis group 22% of mitral valve areas were estimated purely numerically by 2D echo as moderate (greater than 1 cm2).

Adult↗
PubMedDate not supplied

[Phonocardiographic and Doppler echocardiographic study on the mechanism of the presystolic murmur in mitral stenosis, especially the relationship to mitral inflow dynamics].

The cause of the "presystolic murmur" in mitral stenosis was investigated by phonocardiography and continuous wave Doppler echocardiography in 31 patients with mitral stenosis and sinus rhythm classified into two groups: 18 patients with and 13 without "presystolic murmur". 1. The "presystolic murmur" group demonstrated high frequency vibrations preceding the first heart sound coinciding with the initial low frequency component of the first heart sound recorded at the apex in both groups. 2. There were two types of "presystolic murmur": The first type observed in three of the 18 patients occurred during the accelerated phase of the atrial (A) wave of mitral inflow signals and lasted until the first heart sound. The A wave velocity in mitral inflow signals was high at the onset and peak, and rapidly decreased after the peak. The second type observed in 15 patients occurred during the decelerated phase of the A wave and lasted until the first heart sound. The A wave velocity in mitral inflow signals was low at the onset, but high at the peak and rapidly decreased after the peak. 3. The mitral orifice area tended to be smaller in all patients with "presystolic murmur". The peak flow velocity, deceleration rate of the A wave, and maximal pressure gradient across the mitral valve during atrial contraction were significantly increased in all patients with "presystolic murmur". 4. Five patients with newly developed "presystolic murmur" after amyl nitrite inhalation had an increased initial low frequency component of the first heart sound coinciding with the latter half of "presystolic murmur". The rate of increase in the peak flow velocity and the deceleration rate of the A wave were significantly larger and the maximal atrioventricular pressure gradient during atrial contraction tended to be larger in these five patients than those in five who did not develop "presystolic murmur". 5. The peak flow velocity, deceleration rate of the A wave and the maximal atrioventricular pressure gradient during atrial contraction had increased 1 year later compared with those immediately after cardioversion of atrial fibrillation, and newly developed "presystolic murmur" appeared according to the recovery of left atrial mechanical function. These results suggest that the latter half of "presystolic murmur" originates from augmentation and prolongation of the initial low frequency component of the first heart sound up to the audible range caused by the sudden deceleration of mitral inflow velocity due to left ventricular contraction, and that the early half of "presystolic murmur" is the atriosystolic murmur produced by the increase in mitral inflow velocity during atrial contraction.

Blood Flow Velocity↗
PubMed1989

[A successful surgical treatment of mitral stenosis of double mitral valve combined with aortic regurgitation].

The purpose of this paper was to present a successful double mitral commissurotomy concomitant with aortic valve replacement for 45-year-old female who was found to have rheumatic fever in her history. Double mitral valve was incidentally diagnosed by means of preoperative echocardiography. Both orifice areas were almost same and measured as 0.70 and 0.71 cm2 in size. Double mitral commissurotomy was successful to obtain optimal areas of mitral valve at surgery and aortic valve replacement was carried out with #23 Björk Shiley prosthesis. Her postoperative course was uneventful and followed up one year after operation at present. This is the first case in the literature of successful surgical treatment of double mitral commissurotomy combined with aortic valve replacement.

Aortic Valve↗
PubMed1963

The diagnosis of mitral stenosis.

The diagnosis of classical mitral stenosis is easy, but many pitfalls lead to over-diagnosis or under-diagnosis. These have been considered in detail and variations in symptoms and signs have been illustrated by case histories. Such variations include: (1) Embolism producing the Leriche syndrome; (2) mitral stenosis with insignificant hemodynamic effect; (3) myxoma masquerading as mitral stenosis; (4) mitral stenosis without apical murmurs, and (5) mitral stenosis with a systolic murmur predominant or alone. In cases of combined mitral and aortic stenosis, the history, radiographic configuration, and incidence of hemoptysis, edema, bronchitis, embolism and atrial fibrillation resemble such findings in cases of isolated mitral stenosis, but the auscultatory signs of the latter may be obscured. The degree of aortic stenosis is difficult to determine in cases of combined stenosis. In the diagnosis of re-stenosis the condition of the valve at the first commissurotomy, the precise procedure performed and the degree of regurgitation produced are of prime importance. Congenital mitral stenosis is rare and is associated with a high incidence of other defects.

Aortic Valve Stenosis↗