Mitral stenosis

This lesion is almost always (99%) due to rheumatic heart disease although a clear history is obtained in only 50% of cases.

25% of patients with rheumatic heart disease have pure mitral stenosis, two-thirds are female.

In parallel with the incidence of rheumatic fever, mitral stenosis is more common and generally more severe in developing countries.

NICE state (1):

• consider transcatheter valvotomy for adults with rheumatic severe* mitral stenosis, if the valve is suitable for this procedure
• offer surgical mitral valve replacement to adults with rheumatic severe* mitral stenosis if transcatheter valvotomy is unsuitable

* severity of valve disease is defined in line with the British Society of Echocardiography guidelines on the British Heart Foundation's website.

Reference:

1. NICE (November 2021). Heart valve disease presenting in adults: investigation and management