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Mitral Valve disease secondary to rheumatic fever treatable with surgery
The normal cross-sectional area - 5 cm2 and symptoms begin when the valve area is 1-2 cm2. Preexisting rheumatic heart disease causes scarring and contracture of the mitral valve orifice into the classic fish-mouth appearance. Anticoagulation should be started if the patient in AF or Paroxysmal AF or has had previous cardiac emboli in Sinus rhythm. Scarring, contraction and narrowing of the mitral valve cross-sectional area is usually caused by previous rheumatic fever. The result is that there is an obstruction to left ventricular filling resulting in clinical signs and symptoms. Remember the gradient across the mitral valve and pressures involved are much lower than with the aortic valve but the effects can be profound.