Mitral valve stenosis secondary to mitral stenosis is severe, the P (pulmonic) component of the second heart sound (S) will become loud. An opening snap that is a high-pitch additional sound may be heard after the A (aortic) component of the second heart sound (S), which correlates to the forceful opening of the mitral valve. The mitral valve opens when the pressure in the left atrium is greater than the pressure in the left ventricle. This happens in ventricular diastole (after closure of the aortic valve), when the pressure in the ventricle precipitously drops. In individuals with mitral stenosis, the pressure in the
Mitral valve away from the free margin. This disposition has important effects on systolic stress distribution physiology The mitral annulus is a fibrous ring that is attached to the mitral valve leaflets. Unlike prosthetic valves, it is not continuous. The mitral annulus is saddle shaped and changes in shape throughout the cardiac cycle. The annulus contracts and reduces its surface area during systole to help provide complete closure of the leaflets. Expansion of the annulus can result in leaftlets that do not join soundly together, leading to functional mitral regurgitation. The normal diameter of the mitral annulus is , and the circumference