Mitral Stenosis

Causes:

• Rheumatic heart disease
• Bicuspid valve
• Sub valvular fusion
• SLE
• Rheumatiod Arthritis
• Malignant carcinoid syndrome
• Age-calcification

Anaesthetic goals

• Maintain Sius rhythm
• Optimal preload
• Do not increase or decrease SVR
• Avoid myocardial supression
• Maintain heart rate between 60 to 80.

Ref:http://www.emedicine.com/emerg/topic315.htm

Mitral Regurgitation

Causes:

1. Rheumatic heart disease
2. Rupture of chordae
3. Rupture of the papillary muscles
4. Bicuspid valve
5. Prolapse of the valve - Marfans and other connective tissue diseases
6. Perforation - infection, vegetations
7. Volume overload of LV
8. Annular dilatation
9. Dilatational cardiomyopathy

Anaesthetic goals:

1. Maintain adequate preload
2. Maintain higher heart rate (>90/min)
3. Maintain sinus rhythm
4. Avoid increases in the SVR
5. Avoid myocardial depression.