Main pillars of treatment of mitral stenosis
- Look for possibility of recurrence of rheumatic fever – consider penicillins if such possibility is likely.
- Manage shortness of breath if present – consider salt restriction and diuretics
- For those with ATRIAL FIBRILLATION – consider warfarin and drugs that slow ventricular rate (like beta blockers, rate limiting calcium channel blockers eg verapamil, digitalis).➡Maintain warfarin INR between 2 and 3
- If recent onset atrial fibrillation – electrical or chemical cardioversion is done after anticoagulation with warfarin for 3 weeks or more
- Those with history of recent systemic or pulmonary embolism should also be thought for warfarin anticoagulation.
- Symptomatic patients with narrow mitral orifice of about 1.5 cm or less – consider valvotomy of mitral valve.
- Otherwise okay patients with no complications of mitral stenosis may be taken into account for balloon valvuloplasty.