Adult Echocardiography Practice Exam

What is the most common cause of mitral stenosis?

1. Rheumatic fever

2. Calcific degeneration

3. Cardiomyopathy

4. Congenital defects

The correct answer is: Rheumatic fever

Rheumatic fever is the most common cause of mitral stenosis, particularly in developing countries, where it remains a prevalent consequence of untreated streptococcal throat infections. This inflammatory disease can lead to scarring and fusion of the mitral valve leaflets, resulting in narrowing of the valve opening. Over time, the inflammation and subsequent changes can significantly affect the hemodynamics of the heart, causing symptoms such as exertional dyspnea, fatigue, and even heart failure. While calcific degeneration can contribute to mitral stenosis, particularly in the elderly, it is typically less common as a primary cause compared to sequelae from rheumatic heart disease. Cardiomyopathy and congenital defects are also associated with various cardiac conditions but do not primarily lead to mitral stenosis in the majority of cases. Therefore, the association of rheumatic fever with specific valve abnormalities reinforces its standing as the leading cause of this condition.