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.