Why the study?
The authors sought to systematically review and contrast the European and American guidelines on the diagnosis and management of mitral stenosis to appraise clinical judgment.
While ESC and ACC/AHA guidelines agree on anticoagulation for mitral stenosis, they differ in severity staging and surgical indications.
Guideline discrepancies in MS management warrant cautious application; leaves open need for harmonized, evidence-based standards.
A comparison of the recommendations for the diagnosis and management of mitral stenosis (MS), the major cause of valvular heart disease globally, from the European Society of Cardiology/European Association to the American College of Cardiology/American Heart Association 2020 guidelines. We systematically reviewed and contrasted the guidelines on the diagnosis and management of MS to appraise clinical judgment. A multimodel approach includes transesophageal echocardiogram (TEE), transthoracic echocardiogram (TTE), cardiac catheterization, exercise testing, and transcatheter mitral valve repair or replacement/transcatheter mitral valve implantation. Both guidelines agreed on medical therapy, which is anticoagulation, which has been shown to reduce the thromboembolic events in rheumatic MS. On the other hand, there was a subtle difference between both guidelines in staging the severity of MS. In addition, there was a disagreement regarding whether to perform a regular follow-up or to perform surgery.
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Satish K. Parashar (2023) studied this question.
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