Summary
Definition
History and exam
Key diagnostic factors
- dyspnea on exertion
- decreased exercise tolerance
- lower extremity edema
- holosystolic murmur
Other diagnostic factors
- fatigue
- displaced point of maximal impulse
- orthopnea
- paroxysmal nocturnal dyspnea
- palpitations
- diaphoresis
- pulmonary closure is louder than aortic closure
- S3 heart sound
- diminished S1 heart sound
Risk factors
- mitral valve prolapse
- hx of rheumatic heart disease
- infective endocarditis
- hx of cardiac trauma
- hx of MI
- hx of congenital heart disease
- hx of ischemic heart disease
- left ventricular systolic dysfunction
- hypertrophic cardiomyopathy
- anorectic/dopaminergic drugs
Diagnostic investigations
Investigations to consider
- flow convergence method or proximal isovelocity surface area
- color Doppler flow
- transesophageal echocardiogram
- left heart catheterization
- cardiac MRI
Treatment algorithm
Contributors
Authors VIEW ALL
Consultant Cardiothoracic Surgeon
National Heart and Lung Institute
Imperial College Faculty of Medicine
Imperial College Healthcare NHS Trust - Hammersmith Hospital
London
UK
Disclosures
PPP is an author of references cited in this monograph. PPP declares that he has no competing interests.
Dr Prakash P. Punjabi would like to gratefully acknowledge Dr Samir Kapadia and Dr Mehdi H. Shishehbor, previous contributors to this monograph. SK and MHS declare that they have no competing interests.
Peer reviewers VIEW ALL
Fellow
Cardiovascular Imaging Center
Department of Cardiology
Cleveland Clinic Foundation
Cleveland
OH
Disclosures
LR declares that he has no competing interests.
Associate Professor of Medicine
Department of Medicine
Baylor College of Medicine
Houston
TX
Disclosures
RF declares that she has no competing interests.
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