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The natural history of mitral stenosis secondary to rheumatic fever (the most common cause) is an asymptomatic latent phase following the initial episode of rheumatic fever. This latent period lasts an average of 16.3 ± 5.2 years. Once symptoms of mitral stenosis begin to develop, progression to severe disability takes 9.2 ± 4.3 years.
Symptoms of mitral stenosis increase with exercise and pregnancy [16] On auscultation of a patient with mitral stenosis, typically the most prominent sign is a loud S 1. [16] Another finding is an opening snap followed by a low-pitched diastolic rumble with presystolic accentuation.
The symptoms associated with MR are dependent on which phase of the disease process the individual is in. Individuals with acute MR are typically severely symptomatic and will have the signs and symptoms of acute decompensated congestive heart failure (i.e. shortness of breath, pulmonary edema, orthopnea, and paroxysmal nocturnal dyspnea). [6]
axial compression and rotation of cervical spine to the side of symptoms causes pain Stellwag's sign: Karl Stellwag von Carion: endocrinology: thyrotoxicosis: infrequent and/or incomplete blinking, accompanied by Dalrymple's sign: Still's murmur: Sir George Frederick Still: paediatric cardiology: subaortic stenosis, small Ventricular septal defect
In mitral stenosis, tapping apical impulse is present. Mid-diastolic Tricuspid stenosis: Best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S1. May increase in intensity with inspiration (Carvallo's sign). Tricuspid stenosis often occurs in association with mitral stenosis.
Pulmonary congestion: When blood or fluid pools within the lungs; this is usually a symptom of mitral stenosis and a small ASD. Loud mitral S1 and wide fixed split of pulmonary S2: The loud sound of the mitral S1 and the wide fixed split of pulmonary S2 is a symptoms of mitral stenosis.
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