Surgical Treatment of Mitral Valve Disease.

Mitral Stenosis 1. Detection . While the auscultatory findings of mitral stenosis are characteristic , many patients go undetected by routine clinical examination; it is, therefore, important to be aware of the special syndromes with which they may present (Table 1 ). Mitra! stenosis is much more common in women and should be looked for particularly in those who are young or middle-aged . The condition is predominantly a sequel to rheumatic heart disease which is prevalent among large famil ies from lower socioeconomic groups. The availability of M-mode echocardiography in recent years has been of great help in the detection of mitral stenosis, since this procedure has nearly 1 00% sensitivity and the specificity is almost as good . With the two-dimensional echocardiogram the degree of stenosis can be measured with great precision by mapping out the valve area. Echocardiography has thus eliminated the need for cardiac catheterization either for the detection or quantification of mitral stenosis, and cardiac catheterization is now em-