Mitral Stenosis Case Study: Homeostatic Disturbances Explained

This case study presents a 30-year-old male with a history of rheumatic fever, now experiencing exertional dyspnea, orthopnea, and lower limb swelling, indicative of rheumatic mitral stenosis. The patient's history includes intravenous drug abuse. Physical examination revealed an irregular pulse, edema, and an enlarged liver. Cardiovascular examination showed a loud first heart sound, opening snap, and mid-diastolic murmur. Laboratory studies confirmed severe rheumatic mitral stenosis via electrocardiogram and echocardiography. The assignment explores the homeostatic disturbances associated with this condition, including the mechanics of the heart, the impact of the damaged mitral valve, and the resulting physiological responses such as reduced oxygen supply, increased pressure in the left atrium, and congestion in the lungs. The study highlights the importance of understanding the disease process, symptoms, and diagnostic methods, and offers a comprehensive overview of the patient's condition and its implications.

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CASE STUDY ON HEALTHCARE
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What processes are involved that can explain the homeostatic disturbances in
the clinical case scenario?
How the heart works during rheumatic mitral stenosis:
In the case of rheumatic mitral stenosis heart actually works abnormally. We all know that our
heart is the main organ of the circulatory system of our body. Our heart has four basic chambers
or valves. Two of them are atria which actually receive blood from veins and two of them are
ventricles which supply blood throughout the body. Four of those heart chambers opened and
closed in rhythm to let the blood flow normally (Wunderlich et al. 2019). The mitral valve situated
between the left atria and ventricle. This mitral valve consists of two small tissues called leaflets.
This mitral valve opens when blood flows from left atria to ventricle. Then the leaflets become
closed and prevent the blood flew to backwards. But when mitral valve damaged that time it
faces several complications in order to opening and closing (Veeramani et al. 2017). In the case of
mitral valve stenosis, the amount of blood flow gets reduced. Thus the oxygen supply inside the
heart also gets reduced. For this reason, the lungs do not work properly and the patient is
suffering from shortness of breathing and problematic breathing as well which is known as
dyspnoea. In the case of rheumatic mitral valve stenosis the blood creating lots of pressure in the
left atrium thus the left atrium become enlarged and the size of ventricle becomes squeezed.
Mitral valve stenosis is a disease that occurs due to irregular blood flow and some kind of
abnormalities inside the heart. This disease is also considered as the narrowing the heart's
specific mitral valve. In such cases, the heart's mitral valve does not open in a proper way and the
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passage of the blood flow has been blocked (Mahmoud et al. 2018). Thus, the blood cannot get
into the main pumping chamber of the heart. This situation arises mainly because of rheumatic
fever. In this case study, this patient was also suffered from rheumatic fever once in his
childhood. In the case of rheumatic fever, it basically damages the mitral valve of the heart. This
rheumatic mitral stenosis syndrome is a very slow process which gradually damages the heart
and the entire cardiovascular system as well. This kind of situation also arises if somehow blood
clots inside the heart. With the help of electrocardiogram and echocardiogram and
transoesophageal echocardiogram, we can find the abnormalities of the heart's mitral valve
which are generally happened for rheumatic mitral valve stenosis. In the mentioned case study
medical unit have seen some blockages in the patient’s heart and enlarged left atria also found
(Otto, Gaasch and Yeon 2018). This actually confirmed the rheumatic mitral valve stenosis
condition. According to the medical study in case of rheumatic mitral valve stenosis the feet have
been swollen, the affected patients have been suffering from palpitation inside his or heart and
having severe chest pain as well. These all are matched with the mentioned patient who is
diagnosed here with mitral valve stenosis. In the case of mitral valve stenosis lots of pressure
created inside the heart which are slowly spreading to the lungs. The fluids which are built up
during this period create congestion inside the lungs and thus the patient feels the trouble of
breathing.
References:
Mahmoud Elsayed, H.M., Hassan, M., Nagy, M., Amin, A., Elguindy, A., Wagdy, K. and
Yacoub, M., 2018. A novel method to measure mitral valve area in patients with rheumatic
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mitral stenosis using three‐dimensional transesophageal echocardiography: Feasibility and
validation. Echocardiography, 35(3), pp.368-374.
Otto, C.M., Gaasch, W.H. and Yeon, S.B., 2018. Clinical Manifestations and diagnosis of
rheumatic mitral stenosis. UpToDate, Post, TW.
Veeramani, S.R., Ramesh, R., Sankar, R., Balasubramanian, S. and Mohammed, S.N., 2017.
Three-dimensional Echocardiography: A Novel Technique for Rheumatic Mitral Valve Stenosis
Evaluation. Age (years), 32, p.10.
Wunderlich, N.C., Dalvi, B., Ho, S.Y., Küx, H. and Siegel, R.J., 2019. Rheumatic Mitral Valve
Stenosis: Diagnosis and Treatment Options. Current cardiology reports, 21(3), p.14.
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