CARDIOVASCULAR MANIFESTATIONS OF MITRAL STENOSIS IN THE ELDERLY

Abstract

Mitral stenosis has been described as a chronic valvular disease characterized by a reduction in the mitral valve area, resulting in obstruction to diastolic flow from the left atrium to the left ventricle. In elderly patients, this condition has presented relevant clinical particularities, as it has frequently been associated with degenerative processes, mitral annulus calcification, and pre-existing cardiovascular comorbidities. Cardiovascular manifestations were influenced both by the slow progression of the disease and by the physiological changes of aging, favoring increased left atrial pressure, pulmonary congestion, and right ventricular overload. Objective: To analyze the main cardiovascular manifestations associated with mitral stenosis in elderly patients, with emphasis on the pathophysiological mechanisms, hemodynamic repercussions, and clinical implications described in recent scientific literature. Methodology: The methodology was based on the PRISMA checklist and included a search for scientific articles published in the last 10 years in the PubMed, SciELO, and Web of Science databases. Five combined descriptors were used: “mitral valve stenosis”, “elderly”, “cardiovascular manifestations”, “heart failure”, and “atrial fibrillation”. Inclusion criteria included original studies, literature reviews, and scientific books that addressed elderly individuals with mitral stenosis and described cardiovascular manifestations, publications in English, Portuguese, or Spanish, and full texts available. Exclusion criteria included studies with exclusively pediatric or young adult populations, articles that addressed other valvular heart diseases without specific analysis of mitral stenosis, and duplicate publications or those with insufficient data. Results: The results demonstrated that the most frequent cardiovascular manifestations were dyspnea on exertion, atrial fibrillation resulting from left atrial dilation, secondary pulmonary hypertension, and right heart failure. The literature highlighted an increased risk of thromboembolic events, worsening functional capacity, and greater diagnostic complexity in the elderly due to the overlap of symptoms with other cardiovascular diseases. Conclusion: It was concluded that mitral stenosis in elderly individuals presents complex and multifactorial cardiovascular manifestations, associated with the progression of valvular disease and cardiovascular aging. Early identification of these repercussions was described as fundamental for adequate clinical management, contributing to a reduction in complications, improved prognosis, and greater quality of life in this population.