Summary

• Fusion of the leaflet commissures reducing orifice area. Usually occurs as a consequence of rheumatic fever.
• Causes decreased filling of the left ventricle, while simultaneously increasing left atrial pressure, producing the syndrome of heart failure.
• As disease progresses, pulmonary hypertension and right heart failure occur.
• Mild disease can be treated symptomatically with diuretics. Moderate to severe disease requires mechanical correction of the valve obstruction by valvotomy, valve repair, or valve replacement.