Feature |
Mitral Stenosis |
Mitral Regurgitation |
Definition |
Narrowing of the mitral valve opening, causing restricted blood flow from the left atrium to the left ventricle. |
Incompetence of the mitral valve, causing blood to leak back into the left atrium during systole (heart contraction). |
Etiology |
Most commonly caused by rheumatic heart disease, congenital defects, or mitral annular calcification. |
Caused by mitral valve prolapse, rheumatic heart disease, infective endocarditis, or ischemic heart disease. |
Pathophysiology |
Impeded blood flow leads to increased left atrial pressure, pulmonary congestion, and right heart strain. |
Regurgitated blood into the left atrium causes volume overload in both the left atrium and ventricle, leading to dilation and eventually heart failure. |
Symptoms |
Dyspnea (shortness of breath), fatigue, palpitations, hemoptysis (coughing up blood), and orthopnea. |
Fatigue, dyspnea, palpitations, orthopnea, and signs of heart failure (e.g., ankle edema, pulmonary congestion). |
Heart Sounds |
Loud S1, opening snap, and a low-pitched diastolic rumble, best heard at the apex. |
Soft S1, holosystolic (pansystolic) murmur, best heard at the apex and radiating to the axilla. |
Complications |
Atrial fibrillation, pulmonary hypertension, right heart failure, systemic embolization (due to atrial fibrillation). |
Left ventricular failure, atrial fibrillation, pulmonary hypertension, and heart failure. |
Diagnostic Tools |
Echocardiogram (shows thickened, immobile mitral valve leaflets, reduced valve area), CXR (left atrial enlargement, pulmonary congestion). |
Echocardiogram (shows regurgitant flow, dilated left atrium/ventricle), CXR (left atrial/ventricular enlargement, pulmonary congestion). |
Management |
- Diuretics for pulmonary congestion
- Anticoagulation if atrial fibrillation present
- Percutaneous mitral balloon valvotomy (PMBV) or mitral valve surgery in severe cases
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- Diuretics for pulmonary congestion
- Afterload reduction (e.g., ACE inhibitors, vasodilators)
- Surgical valve repair or replacement in severe cases
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