differential diagnosis
Last reviewed 01/2018
The differential diagnosis for mitral stenosis includes:
- atrial fibrillation without mitral stenosis
- primary pulmonary hypertension
- a left to right shunt:
- atrial septal defect - the dilated right ventricle may reach the axilla causing apical short ventricular filling murmurs because of high flow through the tricuspid valve
- ventricular septal defect, patent ductus arteriosus - these conditions may cause mitral flow murmurs
- Austin Flint murmur:
- the murmur of mitral stenosis may be indistinguishable from the Austin Flint murmur of pure aortic regurgitation
- mitral stenosis usually has a loud first heart sound which is absent in aortic regurgitation
- a definite diagnosis may require echocardiography
- left atrial myxoma:
- the tumour may lie in the mitral orifice and so is sometimes misdiagnosed as mitral stenosis
- frequently there are systemic emboli
- diagnosis is made via histology of an embolus or by echocardiography
- Carey-Coombs murmur:
- this is a variable, high-pitched mid-diastolic murmur heard during the acute valvulitic phase of rheumatic fever