skip to main content

Rheumatic Mitral Stenosis — EECC MCQ

Instant feedback + full explanation. One question, done properly.

EasyValvular Heart DiseaseRheumatic Mitral StenosisEECC

A 30-year-old man from Bangladesh presents with progressive exertional dyspnoea. Echocardiography confirms rheumatic mitral stenosis with a valve area of 1.2 cm2 and mean gradient of 12 mmHg. He is in sinus rhythm. What is the most appropriate antithrombotic therapy?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — No antithrombotic therapy required

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D

Per the 2025 ESC/EACTS VHD Guidelines, anticoagulation for mitral stenosis in sinus rhythm without other indications (LA thrombus, prior embolism, dense spontaneous echo contrast) is not routinely recommended. Anticoagulation is indicated if AF develops. DOACs are contraindicated in moderate-severe rheumatic mitral stenosis. Aspirin (A) and clopidogrel (E) are not indicated.

Reference: ESC/EACTS (2025): Guidelines for the Management of Valvular Heart Disease