Mechanical and myocardial factors in rheumatic heart disease with mitral stenosis

Sixteen patients with rheumatic heart disease and pure mitral stenosis, studied by cardiac catheterization, are presented to illustrate the relative importance of mitral block and myocardial insufficiency in this disease. Analysis of hemodynamic data permitted a separation of those patients with predominantly mechanical mitral block from those in whom myocardial insufficiency appeared to be the predominant lesion. The importance of recognizing the existence of the latter group is emphasized, since commissurotomy will not be of benefit in such cases.