Mitral Stenosis

Submitted by:
Nassa,Norhaya L. BSN-3F,B-10

Submitted by:
Sir Mabuhay Apollo Fiesta,RN
CI

Mitral Stenosis
Definition
>is an obstruction of blood flowing from the left atrium into the left
ventricle.It is most often caused by rheumatic endocarditis,w/c progressively
thickens the mitral valve leaflets and chordate tendineae.The leaflets often fuse
together.Eventually,the mitral valve orifice narrows and progressivey obstructs
blood flow into the ventricle.

Pathophysiology

Normally,the mitral valve opening is a wide as the diameter of three fingers.In

cases of marked stenosis,the opening narrows to the width of the pencil.The left
atrium has great difficulty moving blood into the ventricle because of the
increased resistance of the narrowed orifice;iy dilates(stretches) and
hypertrophies(thickens) because of the increased blood volume it holds.Because
there is no valve to protect the pulmonary veins from the backward flow of blood
from the atrium,the pulmonary circulation becomes congested .As a result,the right
ventricle must contract against an abnormally high pulmonary arterial pressure and
is subjected to excessive strain.Eventually,the right ventricle fails.

Mitral stenosis limits the

forward flow of blood
into the left ventricle
Mitral regurtitation
permits blood flow back
into the left atrium.

Increased blood volume and pressure in the left atrium

Left atrium hypertrophy and dilation

Increased blood volume and pressure in the pulmonary veins

Pulmonary congestion(shortness of breath and pulmonary edema),increased

pulmonary vascular pressure

Increased work for the right ventricle,right ventricular strain

Right ventricular failure

Risk Factors:
Predisposing Factors: Precipitating Factors:

>Weak immune system >Beta-hemolytic streptococcus

>Poor sanitation

>Age

Clinical Manifestations

The first symptom of mitral stenosis is often breathing difficulty (ie,dyspnea)on

exertion as a result of pulmonary venous hypertension.Patients w/ mitral stenosis
are likely to show progressive fatigue as result of low cardiac output.They may
expectorate blood (ie,hemoptysis),cough and experience repeated respiratory
infections.

Assessment and Diagnostic Findings

The pulse is weak and often irregular because of atrial fibrillation (caused by
the strain in the atrium).A low-pitched,rumbling,diastolic murmur is heard at the
apex.