Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- history of rheumatic fever
- dyspnea
- orthopnea
- opening snap on auscultation
- diastolic murmur
- loud P2
- neck vein distension
- paroxysmal nocturnal dyspnea
- hemoptysis
- hoarseness
- peripheral edema
- ascites
Outros fatores diagnósticos
- 40-50 years old in rheumatic mitral stenosis, 70-90 years old in mitral annular calcification (MAC)-related disease
- loud first heart sound (S1)
- irregularly irregular pulse
- flushed cheeks
Fatores de risco
- streptococcal infection
- female sex
- ergot medications
- serotonergic medications
- systemic lupus erythematosus (SLE)
- amyloidosis
- bronchial carcinoid syndrome
- atherosclerotic risk factors
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- ECG
- CXR
- transthoracic echocardiography
Investigações a serem consideradas
- transesophageal echocardiography (TEE)
- cardiac catheterization
- dynamic exercise testing
Algoritmo de tratamento
nonpregnant
pregnant
Colaboradores
Autores
Blase Carabello, MD
Professor Emeritus, East Carolina University
Director Valve Program, Roper St Francis Health Care
Charleston
SC
Declarações
BC declares that he has no competing interests.
Revisores
John R. Charpie, MD, PhD
Associate Professor of Pediatrics
Medical Director
Pediatric Cardiothoracic Intensive Care Unit
University of Michigan Congenital Heart Center
C.S. Mott Children's Hospital
Ann Arbor
MI
Declarações
JRC declares that he has no competing interests.
David Leaf, MD, MPH
Professor of Medicine
VA Greater Los Angeles Healthcare System
UCLA School of Medicine
Los Angeles
CA
Declarações
DL declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Stollerman GH. Rheumatogenic streptococci and autoimmunity. Clin Immunol Immunopathol. 1991 Nov;61(2 Pt 1):131-42. Resumo
Fawzy ME, Choi WB, Mimish L, et al. Immediate and long-term effect of mitral balloon valvotomy on left ventricular volume and systolic function in severe mitral stenosis. Am Heart J. 1996 Aug;132(2 Pt 1):356-60. Resumo
Writing Committee Members; Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021 Feb 2;77(4):e25-197.Texto completo Resumo
Wilkins GT, Weyman AE, Abascal VM, et al. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilation. Br Heart J. 1988 Oct;60(4):299-308.Texto completo Resumo
Palacios IF, Sanchez PL, Harrell LC, et al. Which patients benefit from percutaneous mitral balloon valvuloplasty? prevalvuloplasty and postvalvuloplasty variables that predict long-term outcome. Circulation. 2002 Mar 26;105(12):1465-71.Texto completo Resumo
Reyes VP, Raju Bs, Wynne J, et al. Percutaneous balloon valvuloplasty compared with open surgical commissurotomy for mitral stenosis. N Engl J Med. 1994 Oct 13;331(15):961-7.Texto completo Resumo
Subbarao KS, Nachiappan M, Irineu AP. Transventricular mitral commissurotomy in critical mitral stenosis during pregnancy. Asian Cardiovasc Thorac Ann. 2004 Sep;12(3):233-5. Resumo
Delgado V, Ajmone Marsan N, de Waha S, et al. 2023 ESC guidelines for the management of endocarditis: developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM). Eur Heart J. 2023 Oct 14;44(39):3948-4042.Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Left atrial myxoma
- Unexplained atrial fibrillation
Mais Diagnósticos diferenciaisDiretrizes
- 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines
- 2021 ESC/EACTS guidelines for the management of valvular heart disease
Mais DiretrizesFolhetos informativos para os pacientes
Atrial fibrillation
Heart failure
Mais Folhetos informativos para os pacientesVideos
Mitral stenosis (severe)
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