Treatment of mitral stenosis

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.
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