Rheumatic Valvular Disease

  • Elliot Chesler


The mitral valve apparatus is composed of the anterior and posterior leaflets attached by chordae tendinae to their respective papillary muscles. The anterior leaflet is triangular and has a fibrous attachment to the aortic root; the posterior leaflet is quadrangular and is attached to two-thirds of the annulus fibrosis. The two leaflets are joined by commissural tissue. Whereas the anterior leaflet is mobile, the posterior is restricted in its movement and acts as a buttress so that in systole both leaflets are firmly apposed along their margins.


Mitral Valve Aortic Stenosis Mitral Regurgitation Infective Endocarditis Heart Sound 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Armstrong TG, Mitha AS, Weir EK, Chesler E: Non-invasive observation on the initial low frequency vibrations of the first heart sound—correlations with the “presystolic murmur” in mitral stenosis. Br Heat J 40: 750, 1978.CrossRefGoogle Scholar
  2. Bland EF, Jones TD: Rheumatic fever and rheumatic heart disease. A twenty year report on 1000 patients followed since childhood. Circulation 4: 836, 1951.PubMedGoogle Scholar
  3. Criley JM, Hermer AJ: The crescendo presystolic murmur of mitral stenosis with atrial fibrillation. N Engl J Med 285: 1284, 1971.PubMedCrossRefGoogle Scholar
  4. Dack S, Bleifer S, Grishman A, Donoso E: Mitral stenosis: Auscultatory and phonocardiographic findings. Am J Cardiol 5: 815, 1960.PubMedCrossRefGoogle Scholar
  5. Lakier JB, Pocock WA, Gale GE, Barlow JB: Haemodynamic and sound events preceding first heart sound in mitral stenosis. Br Heart J 34: 1152, 1972.PubMedCrossRefGoogle Scholar
  6. Levy MJ, Edwards JE: Anatomy of mitral insufficiency. Prog Cardiovasc Dis 5: 119, 1962.PubMedGoogle Scholar
  7. Olson KH: The natural history of 271 patients with mitral stenosis under medical treatment. Br Heart J 24: 349, 1962.CrossRefGoogle Scholar
  8. Perloff JK, Harvey WP: Clinical recognition of tricuspid stenosis. Circulation 22: 346, 1960.PubMedGoogle Scholar
  9. Rahimtoola, SH: Perspective on valvular heart disease: An update. J.A.C.C. 14: 1: 1–23, 1989.Google Scholar
  10. Rapaport E: Natural history of aortic and mitral valve disease. Am J Cardiol 35: 221, 1975.PubMedCrossRefGoogle Scholar
  11. Spaynuolo M, Kloth N, Taranta A, Doyle E, Pasternack B: Natural history of aortic regurgitation: Criteria predictive of death, congestive heart failure and angina in young patients. Circulation 44: 368, 1971.Google Scholar
  12. Wood P: An appreciation of mitral stenosis: I Clinical features. II Investigations and results. Br Med J 1: 1051, 113, 1954.Google Scholar
  13. Wood P: Aortic stenosis. Am J Cardiol 1: 553, 1958.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag New York, Inc. 1993

Authors and Affiliations

  • Elliot Chesler
    • 1
  1. 1.Veterans Administration Medical CenterUniversity of MinnesotaMinneapolisUSA

Personalised recommendations