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__NOTOC__
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{{Mitral stenosis}}
{{Mitral stenosis}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]
{{CMG}}; {{AE}} {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.; [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{VR}}


==Overview==
==Overview==
The majority of cases of mitral stenosis result from [[rheumatic heart disease]], which occurs as a complication of [[group A streptococcal infection]] in genetically susceptible individuals. Some cases may be [[congenital]].
The most of cases of mitral stenosis is [[rheumatic heart disease]] in developing countries; rare in developed countries (the U.S). [[Rheumatic heart disease]] occurs as a complication of [[group A streptococcal infection]] in genetically susceptible individuals. Less common causes of mitral stenosis include: [[Congenital]], [[mitral annular calcification]], [[rheumatic fever]], [[radiation]] ([[Chest]] [[radiation]]), [[Autoimmune disease|autoimmune diseases]] ([[Lupus]]).


==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
*[[Endocarditis]]
===Common Causes===
===Common Causes===
*[[Bacterial endocarditis]] where the vegetations increase the risk of stenosis
Common causes of mitral stenosis include:<ref name="pmid20435842">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842  }} </ref><ref name="pmid15107043" /><ref name="AllisonCheung2006">{{cite journal|last1=Allison|first1=Matthew A.|last2=Cheung|first2=Philip|last3=Criqui|first3=Michael H.|last4=Langer|first4=Robert D.|last5=Wright|first5=C. Michael|title=Mitral and Aortic Annular Calcification Are Highly Associated With Systemic Calcified Atherosclerosis|journal=Circulation|volume=113|issue=6|year=2006|pages=861–866|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.105.552844}}</ref><ref name="GujralLloyd20162">{{cite journal|last1=Gujral|first1=Dorothy M|last2=Lloyd|first2=Guy|last3=Bhattacharyya|first3=Sanjeev|title=Radiation-induced valvular heart disease|journal=Heart|volume=102|issue=4|year=2016|pages=269–276|issn=1355-6037|doi=10.1136/heartjnl-2015-308765}}</ref><ref name="HasegawaKitahara2001">{{cite journal|last1=Hasegawa|first1=Ryo|last2=Kitahara|first2=Hiroto|last3=Watanabe|first3=Kuniyoshi|last4=Kuroda|first4=Hideo|last5=Amano|first5=Jun|title=Mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome|journal=The Japanese Journal of Thoracic and Cardiovascular Surgery|volume=49|issue=12|year=2001|pages=711–713|issn=1344-4964|doi=10.1007/BF02913510}}</ref><ref name="Tadele-2013">{{Cite journal | last1 = Tadele | first1 = H. | last2 = Mekonnen | first2 = W. | last3 = Tefera | first3 = E. | title = Rheumatic mitral stenosis in Children: more accelerated course in sub-Saharan Patients. | journal = BMC Cardiovasc Disord | volume = 13 | issue = 1 | pages = 95 | month = Nov | year = 2013 | doi = 10.1186/1471-2261-13-95 | PMID = 24180350 }}</ref>
*Congenital mitral stenosis
 
*[[Congenital]]
*[[Infective endocarditis]]
*[[Mitral annular calcification]]
*[[Mitral annular calcification]]
*[[Prosthetic mitral valve]]
*[[Rheumatic fever]]
*[[Radiation treatment]] to the chest
*[[Radiation]] ([[Chest]] [[radiation]])
*[[Rheumatic heart disease]]: This is synonymous with [[rheumatic fever]] which occurs as a complication of [[group A streptococcal infection]] in genetically susceptible individuals.  Rheumatic involvement is found in 99% of stenotic mitral valves evaluated at the time of valve replacement.
*[[Autoimmune disease|Autoimmune diseases]] ([[Lupus]])
*Some medications may cause mitral stenosis


===Causes by Organ System===
===Causes by Organ System===
{|style="width:70%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Atrial myxoma]] that may cause mitral valve obstruction, [[Bacterial endocarditis]] where the vegetations may favor increase risk of stenosis, [[Lutembacher syndrome]], [[Mitral annular calcification]], Primary causes of mitral stenosis that emanate from a cleft [[mitral valve]], [[Prosthetic mitral valve]] and [[Rheumatic heart disease]] which is synonymous with [[rheumatic fever]] that occurs as a complication of [[group A streptococcal infection]] in genetically susceptible individuals.
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Bicuspid aortic valve]], [[coarctation of aorta]], [[cor triatriatum]], [[double orifice mitral valve]], [[endocarditis]], [[endomyocardial fibrosis]], [[hypoplastic left heart syndrome]], [[left atrial myxoma]], [[Thrombus|left atrial thrombus]], [[Loeffler endocarditis]], [[Lutembacher syndrome]], [[mitral annular calcification]], [[Shone's syndrome|parachute mitral valve]], [[Atrioventricular canal surgery|post AV canal defect repair]], [[prosthetic mitral valve]], [[pulmonary veno-occlusive disease]], [[rheumatic fever]], [[Shone's syndrome]], [[Shone's syndrome|supravalve mitral membrane]]  
[[Congenital]] mitral stenosis in which children may be born with mitral stenosis or other birth defects involving the heart that may cause mitral stenosis, such defects include: Double orifice mitral valve, [[Hypoplasia]] of mitral valve annulus which is considered part of the spectrum of [[hypoplastic left heart syndrome]], Mitral valve commissural fusion, [[Shone's syndrome]] (consists a set of four cardiac defects: Parachute mitral valve, Supra-valve mitral membrane (SVMM), Sub-[[aortic stenosis]] and [[Coarctation of the aorta]]) and Thickened [[chordae tendinae]].
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| Some medications may cause mitral stenosis, such as [[Ergot]] preparations used for [[migraine]]s and [[Nitrates]].
|bgcolor="Beige"| [[Ergotamines]], [[methysergide]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| [[Radiation]].
|bgcolor="Beige"| [[Radiation]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Bicuspid aortic valve]], [[coarctation of aorta]], [[congenital]], [[cor triatriatum]], [[double orifice mitral valve]], [[Fabry disease]], [[Hunter syndrome]], [[Hurler syndrome]], [[hypoplastic left heart syndrome ]], [[Lutembacher syndrome]], [[mucopolysaccharidosis]], [[Shone's syndrome|parachute mitral valve]], [[Shone's syndrome]], [[Shone's syndrome|supravalve mitral membrane]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| Blood clots may obstruct the mitral valve.
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Radiation treatment]] to the chest.
|bgcolor="Beige"| [[Atrioventricular canal surgery|Post AV canal defect repair]], [[prosthetic mitral valve]], [[radiation]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Bacterial endocarditis]] where the vegetations may favor increase risk of stenosis.
|bgcolor="Beige"| [[Infective endocarditis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Fabry disease]], [[hemodialysis]], [[Hunter syndrome]], [[Hurler syndrome]], [[mucopolysaccharidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Atrial myxoma]] that may cause mitral valve obstruction.
|bgcolor="Beige"| [[Carcinoid syndrome natural history#Complications|Carcinoid tumor]], [[left atrial myxoma]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]] and [[Rheumatic heart disease]] which is synonymous with [[rheumatic fever]] that occurs as a complication of [[group A streptococcal infection]] in genetically susceptible individuals.
|bgcolor="Beige"| [[Amyloidosis]], [[ankylosing spondylitis]], [[Loeffler endocarditis]], [[rheumatoid arthritis]], [[systemic lupus erythematosus]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|}
|}


==Causes in Alphabetical Order==
===Causes in Alphabetical Order===
*[[Atrial myxoma]]
{{col-begin|width=80%}}
 
{{col-break|width=33%}}
*[[Bacterial endocarditis ]]
*[[Amyloidosis]]
 
*[[Ankylosing spondylitis]]
*[[Coarctation of the aorta]]
*[[Bicuspid aortic valve]]
 
*[[Carcinoid syndrome natural history#Complications|Carcinoid tumor]]<ref name="Fox-2004">{{Cite journal | last1 = Fox | first1 = DJ. | last2 = Khattar | first2 = RS. | title = Carcinoid heart disease: presentation, diagnosis, and management. | journal = Heart | volume = 90 | issue = 10 | pages = 1224-8 | month = Oct | year = 2004 | doi = 10.1136/hrt.2004.040329 | PMID = 15367531 }}</ref>
*Congenital mitral stenosis
*[[Coarctation of aorta]]
 
*[[Congenital]]<ref name="Collins-Nakai-1977">{{Cite journal | last1 = Collins-Nakai | first1 = RL. | last2 = Rosenthal | first2 = A. | last3 = Castaneda | first3 = AR. | last4 = Bernhard | first4 = WF. | last5 = Nadas | first5 = AS. | title = Congenital mitral stenosis. A review of 20 years' experience. | journal = Circulation | volume = 56 | issue = 6 | pages = 1039-47 | month = Dec | year = 1977 | doi = | PMID = 923042 }}</ref>
*[[Cor triatriatum]]
*[[Cor triatriatum]]
 
*[[Double orifice mitral valve]]
*Double orifice mitral valve
*[[Endomyocardial fibrosis]]
 
*[[Ergotamines]]
*[[Fabry disease]]
*[[Hemodialysis]]
{{col-break|width=33%}}
*[[Hunter syndrome]]<ref name="Lee-2013">{{Cite journal | last1 = Lee | first1 = SH. | last2 = Kim | first2 = J. | last3 = Choi | first3 = JH. | last4 = Yun | first4 = KW. | last5 = Sohn | first5 = CB. | last6 = Han | first6 = DC. | last7 = Kim | first7 = JS. | last8 = Park | first8 = YH. | last9 = Kim | first9 = JH. | title = Severe mitral stenosis secondary to Hunter's syndrome. | journal = Circulation | volume = 128 | issue = 11 | pages = 1269-70 | month = Sep | year = 2013 | doi = 10.1161/CIRCULATIONAHA.113.001688 | PMID = 24019448 }}</ref>
*[[Hurler syndrome]]
*[[Hypoplastic left heart syndrome]]
*[[Hypoplastic left heart syndrome]]
 
*[[Infective endocarditis]]<ref name="Tiong-2002">{{Cite journal | last1 = Tiong | first1 = IY. | last2 = Novaro | first2 = GM. | last3 = Jefferson | first3 = B. | last4 = Monson | first4 = M. | last5 = Smedira | first5 = N. | last6 = Penn | first6 = MS. | title = Bacterial endocarditis and functional mitral stenosis: a report of two cases and brief literature review. | journal = Chest | volume = 122 | issue = 6 | pages = 2259-62 | month = Dec | year = 2002 | doi = | PMID = 12475876 }}</ref>
*[[Infective endocarditis]]
*[[Left atrial myxoma]]
 
*[[Thrombus|Left atrial thrombus]]
*[[Loeffler endocarditis]]
*[[Lutembacher syndrome]]
*[[Lutembacher syndrome]]
 
*[[Methysergide]]
*[[Mitral annular calcification]]
*[[Mitral annular calcification]]<ref name="Osterberger-1981">{{Cite journal | last1 = Osterberger | first1 = LE. | last2 = Goldstein | first2 = S. | last3 = Khaja | first3 = F. | last4 = Lakier | first4 = JB. | title = Functional mitral stenosis in patients with massive mitral annular calcification. | journal = Circulation | volume = 64 | issue = 3 | pages = 472-6 | month = Sep | year = 1981 | doi = | PMID = 7261279 }}</ref>
 
*[[Mucopolysaccharidosis]]
*[[Mitral valve annular calcification]]
{{col-break|width=33%}}
 
*[[Shone's syndrome|Parachute mitral valve]]
*Mitral valve commissural fusion
*[[Atrioventricular canal surgery|Post AV canal defect repair]]
 
*Parachute mitral valve
 
*[[Prosthetic mitral valve]]
*[[Prosthetic mitral valve]]
 
*[[Pulmonary veno-occlusive disease]]
*[[Prosthetic mitral valve]]
*[[Radiation]]
 
*Radiation treatment to the chest
 
*[[Rheumatic fever]]
*[[Rheumatic fever]]
 
*[[Rheumatoid arthritis]]
*[[Rheumatic heart disease]]
 
*[[Shone's syndrome]]
*[[Shone's syndrome]]
 
*[[Shone's syndrome|Supravalve mitral membrane]]
*Sub-aortic stenosis
*[[Systemic lupus erythematosus]]
 
*[[Whipple disease]]
*Supra-valve mitral membrane (SVMM)
{{col-end}}
 
*Thickened chordae tendinae
 
*Thrombus (ball valve thrombus)
 
*Cleft mitral valve


==References==
==References==
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Latest revision as of 20:25, 9 April 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.; Mohammed A. Sbeih, M.D. [3]; Vendhan Ramanujam M.B.B.S [4]

Overview

The most of cases of mitral stenosis is rheumatic heart disease in developing countries; rare in developed countries (the U.S). Rheumatic heart disease occurs as a complication of group A streptococcal infection in genetically susceptible individuals. Less common causes of mitral stenosis include: Congenital, mitral annular calcification, rheumatic fever, radiation (Chest radiation), autoimmune diseases (Lupus).

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Common causes of mitral stenosis include:[1][2][3][4][5][6]

Causes by Organ System

Cardiovascular Bicuspid aortic valve, coarctation of aorta, cor triatriatum, double orifice mitral valve, endocarditis, endomyocardial fibrosis, hypoplastic left heart syndrome, left atrial myxoma, left atrial thrombus, Loeffler endocarditis, Lutembacher syndrome, mitral annular calcification, parachute mitral valve, post AV canal defect repair, prosthetic mitral valve, pulmonary veno-occlusive disease, rheumatic fever, Shone's syndrome, supravalve mitral membrane
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Ergotamines, methysergide
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental Radiation
Gastroenterologic No underlying causes
Genetic Bicuspid aortic valve, coarctation of aorta, congenital, cor triatriatum, double orifice mitral valve, Fabry disease, Hunter syndrome, Hurler syndrome, hypoplastic left heart syndrome , Lutembacher syndrome, mucopolysaccharidosis, parachute mitral valve, Shone's syndrome, supravalve mitral membrane
Hematologic No underlying causes
Iatrogenic Post AV canal defect repair, prosthetic mitral valve, radiation
Infectious Disease Infective endocarditis
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic Fabry disease, hemodialysis, Hunter syndrome, Hurler syndrome, mucopolysaccharidosis
Obstetric/Gynecologic No underlying causes
Oncologic Carcinoid tumor, left atrial myxoma
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy Amyloidosis, ankylosing spondylitis, Loeffler endocarditis, rheumatoid arthritis, systemic lupus erythematosus
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.
  2. Allison, Matthew A.; Cheung, Philip; Criqui, Michael H.; Langer, Robert D.; Wright, C. Michael (2006). "Mitral and Aortic Annular Calcification Are Highly Associated With Systemic Calcified Atherosclerosis". Circulation. 113 (6): 861–866. doi:10.1161/CIRCULATIONAHA.105.552844. ISSN 0009-7322.
  3. Gujral, Dorothy M; Lloyd, Guy; Bhattacharyya, Sanjeev (2016). "Radiation-induced valvular heart disease". Heart. 102 (4): 269–276. doi:10.1136/heartjnl-2015-308765. ISSN 1355-6037.
  4. Hasegawa, Ryo; Kitahara, Hiroto; Watanabe, Kuniyoshi; Kuroda, Hideo; Amano, Jun (2001). "Mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome". The Japanese Journal of Thoracic and Cardiovascular Surgery. 49 (12): 711–713. doi:10.1007/BF02913510. ISSN 1344-4964.
  5. Tadele, H.; Mekonnen, W.; Tefera, E. (2013). "Rheumatic mitral stenosis in Children: more accelerated course in sub-Saharan Patients". BMC Cardiovasc Disord. 13 (1): 95. doi:10.1186/1471-2261-13-95. PMID 24180350. Unknown parameter |month= ignored (help)
  6. Fox, DJ.; Khattar, RS. (2004). "Carcinoid heart disease: presentation, diagnosis, and management". Heart. 90 (10): 1224–8. doi:10.1136/hrt.2004.040329. PMID 15367531. Unknown parameter |month= ignored (help)
  7. Collins-Nakai, RL.; Rosenthal, A.; Castaneda, AR.; Bernhard, WF.; Nadas, AS. (1977). "Congenital mitral stenosis. A review of 20 years' experience". Circulation. 56 (6): 1039–47. PMID 923042. Unknown parameter |month= ignored (help)
  8. Lee, SH.; Kim, J.; Choi, JH.; Yun, KW.; Sohn, CB.; Han, DC.; Kim, JS.; Park, YH.; Kim, JH. (2013). "Severe mitral stenosis secondary to Hunter's syndrome". Circulation. 128 (11): 1269–70. doi:10.1161/CIRCULATIONAHA.113.001688. PMID 24019448. Unknown parameter |month= ignored (help)
  9. Tiong, IY.; Novaro, GM.; Jefferson, B.; Monson, M.; Smedira, N.; Penn, MS. (2002). "Bacterial endocarditis and functional mitral stenosis: a report of two cases and brief literature review". Chest. 122 (6): 2259–62. PMID 12475876. Unknown parameter |month= ignored (help)
  10. Osterberger, LE.; Goldstein, S.; Khaja, F.; Lakier, JB. (1981). "Functional mitral stenosis in patients with massive mitral annular calcification". Circulation. 64 (3): 472–6. PMID 7261279. Unknown parameter |month= ignored (help)


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