Normal cross sectional mitral valve area is 4 to 6 square cm. Insufficiency often precedes stenosis. Reduction in CO often causes patients to become easily fatigued, or dizzy.
Obstruction causes a rise in atrial pressure and pulmonary wedge pressure.
Jugular venous pulse reveals prominent a waves from vigorous right atrial systole. Right ventricular tap along the left sternal border signifying an enlarged right ventricle Diastolic thrill at the cardiac apex Loud first heart sound, opening snap with diastolic rumble With pulmonary hypertension, pulmonary component of the second heart sound is accentuated with second heart sound closely split. EKG The P wave suggests left atrial enlargement. Tall and peaked in lead II when right atrial enlargement occurs. Infective endocarditis is rare in pure MS, but commonly seen in patients with combined stenosis and regurgitation.