clinical and echocardiographic study of mitral stenosis in imam khomeini and amir-alam hospitals

rheumatic heart disease is a serious health problem in developing countries. the present study was conducted to evaluate clinical and echocardiographic findings of mitral stenosis and their relationship with patients functional classes. we studied records of 400 patients with symptomatic mitral stenosis (71% female, mostly in 20s or 30s and 54% function class ii) treated in two hospitals in tehran, imam khomeini and amir-alam hospital, from 1994 to 1998. clinical and echocardiographic data were extracted and analyzed. the most prevalent symptoms were dyspnea (96%), palpitation (41%) and chest pain (26%). orthopnea, paroxysmal nocturnal dyspnea, hemoptysis and right heart failure were significantly correlated with functional class and severity of mitral valve stenosis (p<0.05). 41% of patients presented with atrial fibrillation at admission or during hospitalization. this arrhythmia had no relationship with age mitral valve area, although it was significantly correlated with left atrial diameter (p<0.05). diagnosis and management of rheumatic heart disease need accurate physical examination and history taking and careful application of noninvasive and invasive procedures.