Mitral Stenosis Page

Introduction

Welcome to the mitral stenosis page. On this page we provide a definition, sample heart sounds and links to the training lessons available on this site.

What is mitral stenosis?

Mitral stenosis is a heart condition wherein blood flowing through the mitral valve is restricted due to the valve not fully opening.

Diagnosis

Mitral stenosis can be diagnosed during a physical exam. As described below and in our on-line courses, mitral stenosis produces several observable heart sounds. Echocardiography and heart catheterization may also be used in diagnosis of mitral stenosis.

Mitral Stenosis Heart Sounds

The simulated heart sounds found below is an example of moderate mitral stenosis which is most commonly due to rheumatic heart disease. The first heart sound is increased in intensity due to moderate thickening of the the mitral valve leaflets. The second heart sound is normal and unsplit This moderate case of mitral stenosis has a silent systole. There is an opening snap 75 milliseconds into diastole. As mitral stenosis becomes more severe the opening snap will occur earlier in diastole. The opening snap is followed by a diamond shaped low frequency murmur. Use the bell of the stethoscope to hear this murmur. There is a second murmur in late diastole due to contraction of the left atrium. In the animation you can see the turbulent blood flow from the left atrium into the left ventricle. You can see the moderately thickened mitral valve leaflets and the moderately enlarged left atrium. The excursion of the mitral valve leaflets is moderately decreased.

Supine left side down

Bell

Patient Normal Speed

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Patient Half Speed

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Simulated Full Speed

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Listening Tips

S1: Increased intensity.
Diastole: Opening snap followed by diamond shaped, low pitched murmur.