Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of moderate mitral stenosis. Reports progressive exertional dyspnea (NYHA class [I/II/III]), occasional palpitations, and reduced exercise tolerance. Denies orthopnea, PND, hemoptysis, or syncope. No current symptoms of systemic embolization.
Clinical Examination Findings
Cardiovascular exam reveals a regular/irregular rhythm with a loud S1 and an opening snap followed by a low-pitched diastolic rumbling murmur at the apex, best heard in the left lateral decubitus position. No signs of right-sided heart failure (no JVD, no peripheral edema, no hepatomegaly). Lungs are clear to auscultation bilaterally.
Treatment Protocol
Continue current management: [Beta-blocker/Rate control agent] for heart rate optimization. Maintain strict adherence to antibiotic prophylaxis for dental procedures if indicated. Monitor for atrial fibrillation. Advise salt restriction and weight management. Schedule repeat TTE in [6/12] months to monitor valve area and mean gradient.