mitral stenosis

Last edited 11/2021 and last reviewed 11/2021

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.


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