What are the current guidelines for the management of symptomatic mitral stenosis in adults?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Management of symptomatic mitral stenosis in adults:

  • Adults with symptomatic severe mitral stenosis should be offered an intervention.
  • Consider transcatheter valvotomy for adults with rheumatic severe mitral stenosis if the valve anatomy is suitable for this procedure.
  • If transcatheter valvotomy is unsuitable, offer surgical mitral valve replacement.
  • For adults with moderate to severe mitral stenosis and heart failure, consider beta-blocker therapy as part of pharmacological management.
  • Refer adults with moderate or severe mitral valve disease to a specialist for assessment and management.

These recommendations emphasize the importance of specialist referral, consideration of valve intervention based on severity and symptoms, and tailored pharmacological treatment for heart failure symptoms associated with mitral stenosis.

References:

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