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European Heart Journal 1991 12(Supplement B):81-83; doi:10.1093/eurheartj/12.suppl_B.81
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Does mitral stenosis need invasive investigation?

S. Nitter-Hauge

Medical Department B, University of Oslo, The National Hospital Oslo, Norway

Correspondence: Dr. S. Nitter-Huge, Medical Department B, University of Oslo, The National Hospital, Oslo, Norway.

Evaluation without catheterization of patients with valvular heart disease implies that diagnosis based upon noninvasive techniques alone are qualitatively and quantitatively correct. The diagrzosis should indicate not only the valvular lesion in question but should give information about associated conditionr that could influence management decisions (whether to operate or not or whether to modify the intended operation). A review of the literature shows that in mitral stenosis (MS), both pressure gradient and valve area can be obtained noninvasively (rest/exercise). These data, combined with the ultrasound appearance of the valve, subvalvular apparatus, chamber sizes, assessment of associated regurgitation and eventual pulmonary hypertension, permit a complete evaluation of the MS patient. Thus, it can be concluded that in experienced hands, the large majority of patients with MS can be assessed reliably noninvasively for clinical screening and for valve surgery. Excluding those in whom coronary angiography is mandatory, cardiac catheterization should be required only infrequently (in less than 10%). Cardiac catheterization should, however, be carried out in patients in whom technical reasons make ultrasound examinaabns incomplete (obesity or respiratory disease), the physical signs and the Doppler ultrasound.

Key Words: Mitral stenosis • echo Doppler • catheterization


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