Evaluation of the severity of mitral stenosis in patient with pulmonary hypertension: Role of exercise hemodynamics

Catheter Cardiovasc Interv. 2019 Aug 1;94(2):301-307. doi: 10.1002/ccd.28381. Epub 2019 Jun 27.

Abstract

Dyspnea due to mitral stenosis (MS) and/or pulmonary hypertension (PHT) in patients who may have both conditions presents a challenging diagnostic dilemma. The hemodynamic response to exercise is probably the most helpful method to arrive at the correct diagnosis and treatment algorithm. In this hemodynamic rounds discussion, we evaluated a patient with MS and PHT prior to the decision for mitral valvuloplasty. KEY POINTS: Symptoms in patients with mitral stenosis and pulmonary hypertension cannot always be attributed to one pathology. Catheter-based hemodynamics are often needed to differentiate valve from lung disease. Exercise hemodynamics can clarify the predominant pathology in complex clinical scenarios.

Keywords: mitral stenosis; pulmonary hypertension.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cardiac Catheterization*
  • Exercise Test*
  • Female
  • Hemodynamics*
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / diagnosis*
  • Hypertension, Pulmonary / physiopathology
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / physiopathology*
  • Mitral Valve Stenosis / complications
  • Mitral Valve Stenosis / diagnosis*
  • Mitral Valve Stenosis / physiopathology
  • Predictive Value of Tests
  • Severity of Illness Index