Rapaport E
San Francisco General Hospital, University of California, Cardiology Division, CA 94110.
Heart Dis Stroke. 1993 Jan-Feb;2(1):64-8.
Mitral stenosis may be recognized simply on routine physical examination from abnormalities on auscultation, which are subsequently confirmed by Doppler echocardiographic examination. The diagnosis may also be suspected in patients in whom the history is suggestive of rheumatic fever and in whom physical diagnosis reveals findings indicative of mitral stenosis. Occasional cases of mitral stenosis are picked up in the Doppler echocardiography laboratory when a patient has not been suspected of having mitral stenosis but in whom a routine echocardiogram has been taken, for whatever reason. If there is any doubt about the presence of mitral stenosis, confirming the presence of a diastolic pressure gradient across the mitral valve during cardiac catheterization permits one to make a definitive diagnosis as well as estimate the area of the stenotic valve orifice. Intervention with either surgery or balloon valvotomy is indicated when the mitral valve area falls to < or = 1.2 cm2 in a symptomatic patient.
二尖瓣狭窄可通过听诊异常在常规体格检查时被简单识别，随后经多普勒超声心动图检查得以证实。对于有风湿热病史且体格检查发现提示二尖瓣狭窄的患者，也可能怀疑该诊断。偶尔，在未怀疑患有二尖瓣狭窄但因某种原因进行了常规超声心动图检查的患者中，二尖瓣狭窄病例会在多普勒超声心动图实验室被发现。如果对二尖瓣狭窄的存在有任何疑问，在心脏导管检查时确认二尖瓣跨瓣舒张期压力阶差的存在有助于做出明确诊断，并估计狭窄瓣膜口的面积。对于有症状的患者，当二尖瓣瓣口面积降至≤1.2平方厘米时，需行手术或球囊瓣膜成形术干预。
