Mitral valve stenosis class III or IV symptoms. Once an individual develops NYHA class III or IV symptoms, the progression of the disease accelerates and the patient's condition deteriorates. Upon auscultation of an individual with mitral stenosis, the first heart sound is usually loud and may be palpable (tapping apex beat) because of increased force in closing the mitral valve. The first heart sound is made by the mitral and tricuspid heart valves closing. These are normally synchronous, and the sounds are termed M1 and T1, respectively. M1 becomes louder in mitral stenosis. It may be the most prominent sign. If pulmonary hypertension
Mitral valve the left ventricle. It has two leaflets (or 'cusps'), an anteromedial leaflet, and a posterolateral leaftlet. The opening of the mitral valve is surrounded by a fibrous ring known as the "mitral annulus". The anterior cusp covers approximately two-thirds of the valve (imagine a crescent moon within the circle, where the crescent represents the posterior cusp). Although the anterior leaflet takes up a larger part of the ring and rises higher, the posterior leaflet has a larger surface area. The valve leaflets are prevented from prolapsing into the left atrium by the action of chordae tendineae. The chordae tendineae are