ABSTRACT
The etiology of mitral stenosis (MS) in the elderly as in the young patient is chronic
rheumatic heart disease. There is a small incidence of mitral annular calcification with
exuberant atherosclerotic encroachment from the annulus into the base of the left ventricle
such that the mitral orifice is decreased, producing some degree of mitral stenosis, most
often not severe. Reduced anterior leaflet mobility seems to be necessary to produce
obstruction sufficient for a gradient of greater than 5 mmHg (1).
