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|Year : 1979 | Volume
| Issue : 4 | Page : 239-240
Congenital mitral stenosis
Lilam S Shah, AS Vengsarkar
Department of Cardiology, K.E.M Hospital, Parel, Bombay 400012, India
Lilam S Shah
Department of Cardiology, K.E.M Hospital, Parel, Bombay 400012
Source of Support: None, Conflict of Interest: None
Echocardiographic features of congenital mitral stenosis in a six year old female child is described. A significantly reduced amplitude of anterior mitral leaflet (8 mm.) in early diastole suggested a tight mitral stenosis with moderate degree of hypoplasia of the left ventricle. Post-operatively echocardiogram was repeated; it was compared with the pre-operative echocardiogram.
|How to cite this article:|
Shah LS, Vengsarkar A S. Congenital mitral stenosis. J Postgrad Med 1979;25:239-40
| :: Introduction|| |
Echocardiography has been found t, be very much useful in diagnosing con genital malformations affecting the mitral valve, primarily or secondarily. ,, These malformations include mitral atresia, congenital mitral stenosis, hypoplastic left heart syndrome and cor triatriatum.
| :: Case report|| |
A six year old female child presented to us with the complaints suggestive of repeated attacks of respiratory tract infection, effort intolerance (dyspnoea class II) and precordial pulsations since early childhood. There was no history of rheumatic joint pains. Clinical features were suggestive of mitral stenosis of severe degree. Echocardiographic studies revealed abnormal anterior motion of the posterior mitral leaflet (PML) during the diastole. EF slope was 7 mm/sec. Both the leaflets were thin. Early diastolic opening amplitude (DE) was 8 mm (See [Figure 1] on page 238B), suggesting tight mitral stenosis with moderate degree of hypoplasia of the left ventricle. Left atrial size was 2, cm. There was no evidence of mitral valve calcification.
In view of the early onset of symptoms and clinical and echocardiographic findings, a possibility of congenital mitral stenosis was thought of. The child was subjected to mitral valve commissurotomy. Post-operative echo (See [Figure 2] on page 238B) showed improvement in diastolic slope (EF 40 mm/sec.). Posterior mitral leaflet showed diastolic posterior motion. Opening ampliude (DE) was 10 mm.
| :: Discussion|| |
A preliminary report under the use of reflected ultrasound for studying congenital heart malformation in children has been published by Lundstrom et al  The same authors have published echocardiographic diagnosis of mitral atresia, congenital mitral stenosis, hypoplasia of the left ventricle and cor triatriatum. , Magnitude of the opening amplitude can help to decide the severity of mitral stenosis. Small opening amplitude of the anterior mitral leaflet in early diastole suggests tight mitral stenosis, combined with moderate or severe degree of hypoplasia of the left ventricle, or moderate mitral stenosis combined with severe degree of hypoplasia of the left ventricle. The other group is characterized by less reduced opening amplitude of the anterior mitral leaflet. This suggests mild mitral stenosis with moderate degree of hypoplasia of the left ventricle.
According to this classification, our case belongs to the first group where opening amplitude of anterior mitral leaflet was reduced to 8 mm. suggesting tight mitral stenosis with moderate degree of left ventricular hypoplasia. At surgery, the patient was found to have a congenital tight mitral stenosis.
Some other features reported in literature were not present in this case.
| :: References|| |
|1.||Kronzon, I. and Mehta, S. S.: Giant left atrium. Chest, 65: 677-679, 1974. |
|2.||Lundstrom, N. R.: Echocardiography in the diagnosis of results of mitral valvotomy. Circulation, 46: 44-54, 1972. |
|3.||Lundstrom, N. R.: Ultrasound cardiographic studies of the mitral valve lesion in young infants with mitral atresia, mitral stenosis, hypoplasia of left ventricle and cor triatriatum. Circulation, 45: 324-334, 1972. |
|4.||Lundstroma, N. R. and Edler, I.: Ultrasound cardiography in infants and children. Acta Paediat. Scandinav., 60: 117128, 1971. |
|5.||Meyer, R. A. and Kaplan, S.: Echocardiography in the diagnosis of hypoplasia of the left or right ventricle in the neonate. Circulation, 46: 55-64, 1972. |
|6.||Moss, A. J., Gussoni, C. C. and IsabelJones, J.: Echocardiography in congenital heart disease. Western J. Med., M102-121, 1976 |
[Figure 1], [Figure 2]