Principals of clinical examinations of mitral stenosis prior to invasive treatment

: Mitral stenosis, being a progressive disease, remains even at present an important specialized diagnostic field of cardiology which deserves special attention. Although a substantial regression of rheumatic disease was recorded in our country, we have to take into account that there are patients after surgery of mitral stenosis made in the past, that restenosis may develop and that there is also a certain number of non-rheumatic forms of mitral stenosis. Clinical cardiological examination still remains the basis for evaluation of mitral stenosis. A central position in the diagnosis of mitral stenosis for assessment of structural morphological changes in the area of the mitral valve and functional flow changes in the cardiac area is played by echocardiography which, when modern techniques are used, usually suffices for indication of invasive treatment on the stenotic mitral valve. The drug of choice in selected patients with mitral stenosis is balloon mitral commissurotomy which clearly dominates in the majority of patients needing a radical procedure and leads to release of the close block in this area and substantial improvement or sometimes complete disappearance of the symptomatology of the disease. Similarly as in surgical commissurotomy this invasive procedure must be described as palliative and not as a curative procedure.