Mitral valve disorders

Mitral stenosis
The main cause of narrowing (less than 2 cm²) of the mitral valve is rheumatic heart disease, which occurs in patients who have had acute rheumatic fever. This disease has now become rare in Northern Europe. Other exceptional causes include lupus erythematosus, rheumatoid arthritis, radiotherapy, etc.

• Atrial fibrillation.
• Exertional or positional dyspnoea reflects an increase in left atrial pressure during exertion or when moving into a lying position.
• Pulmonary oedema.
• Cerebrovascular thromboembolic accident (CVA), resulting from the expulsion of a clot formed in the left atrium, most often associated with atrial fibrillation.

If the patient initially needs to be treated with medication, valve repair (less frequently possible than in mitral regurgitation, see below) or valve replacement—either with a biological or a mechanical valve—is generally required as soon as symptoms occur.