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Mitral Stenosis — RACP Adult Medicine MCQ

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ModerateCardiologyMitral StenosisRACP Adult Medicine

A 54-year-old woman presents with progressive exertional dyspnoea. Echocardiography shows a mitral valve area of 1.2 cm² with a mean gradient of 12 mmHg. She is in sinus rhythm. What is the most appropriate next step?

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Correct answer: E — Commence beta-blocker and diuretic

This patient has moderate mitral stenosis (valve area 1.0–1.5 cm²). Initial management includes rate control with beta-blockers to prolong diastolic filling time and diuretics for symptom relief. Anticoagulation is indicated for AF, left atrial thrombus, or prior embolism but not for sinus rhythm alone. Intervention is considered for severe MS (area <1.0 cm²) or significant symptoms despite medical therapy.

Reference: eTG – 2025 – Cardiovascular; CSANZ – 2021 – Valvular Heart Disease Guidelines