Mitral stenosis/二尖瓣狭窄

Rheumatic fever, which is the predominant aetiology of MS, has greatly decreased in industrialized countries; nevertheless, MS still results in significant morbidity and mortality worldwide.
The patient with MS may feel asymptomatic for years and then present with a gradual decrease in activity. Symptomatic patients have a poor prognosis without intervention!
Echocardiography is the main method used to assess the severity and consequences of MS
In current practice, surgery for MS is mostly valve replacement (95%) as a result of increasingly elderly presentation and unfavourable valve characteristics for valve repair. Operative mortality for valve replacement ranges from 3–10% and correlates with age, functional class, pulmonary hypertension, and presence of CAD. Long-term survival is related to age, functional class, AF, pulmonary hypertension, preoperative LV/RV function, and prosthetic valve complications.
Medical therapy:
Diuretics or long-acting nitrates transiently ameliorate dyspnoea. Beta-blockers or heart-rate regulating calcium channel blockers can improve exercise tolerance. Anticoagulant therapy with a target INR in the upper half of the range 2 to 3 is indicated in patients with either permanent or paroxysmal AF. Aspirin and other antiplatelet agents are not valid alternatives.