Mitral Stenosis

Mitral Area Murmur
[Apex]
Diastolic

 

  • Most commonly seen in rheumatic heart disease.
  • May be congenital [much less common] other causes: cardiac tumors, mucopoly saccharidoses, Carcinoid, Endomyocarfial Fibroelastosis.
  • Opening snap usually present. Distance between opening snap and S2 decreases as severity of stenoisis increases.
  • Usually associated with a low-pitched diastolic rumble.
  • May be associated with a systolic murmur as well.
  • P2 may be palpable.
  • Right ventricular lift may be present.
  • S1 often accentuated.
  • Prominent Jugular vein A waves (when in sinus rhythm).
  • Edema and liver engorgement present in severe cases.