ABSTRACT
Mitral stenosis is the most common cause of left ventricular inflow obstruction. The most common cause of mitral stenosis is rheumatic carditis, despite its decline in developing countries since the introduction of penicillin. Transesophageal echocardiography offers no real advantage over transthoracic techniques in rheumatic mitral stenosis, unless the patient does not have a suitable transthoracic acoustic window. The real advantage of transesophageal echocardiography in mitral stenosis is in diagnosing associated cardiac pathology such as mitral insufficiency, thrombi in the left atrial cavity and appendage, and assessing the integrity of the atrial septum. Transesophageal echocardiography is particularly helpful in assessing the suitability for, and predicting the results of, percutaneous balloon mitral valvuloplasty, surgical repair and/or commissurotomy. In diagnosing the other causes of mitral or left ventricular inflow obstruction – congenital mitral stenosis, parachute mitral valve, mitral arcade, supravalvular mitral ring, cor triatriatum, left heart or mitral apparatus tumors or thrombi, bacterial or non-bacterial endocarditis, and severe mitral annular calcification – transesophageal echocardiogra-
phy has a distinct advantage over transthoracic echocardiography.
