Mitral Stenosis

SECTIONS

Mitral Stenosis

LEOs undergoing initial evaluation for mitral stenosis can be cleared for full duty if they meet all of the following criteria:

  • Asymptomatic (g., no symptoms of reduced cardiac output, no signs of arterial emboli, etc.)
  • Recent (within past 12 months) ECG with normal sinus rhythm or benign deviations from normal sinus rhythm
  • Recent (within past 12 months) EST to at least 12 METS with normal findings
  • Recent (within past 12 months) echocardiogram showing Stage A or Stage B mitral stenosis (Table 1)

Follow-up Evaluation for Mitral Stenosis: LEOs with mitral stenosis should have an annual medical evaluation by a cardiologist or other physician knowledgeable in the treatment of cardiac valvular disease. For individuals who are asymptomatic with normal left ventricular function, the frequency of follow-up echocardiogram is determined by the severity of the stenosis. For a Stage A or B, echocardiograms should be performed every 3-5 years.1 Results of both the physician evaluations and the echocardiograms should be shared with the agency’s medical provider.

Post-percutaneous Balloon Valvotomy: LEOs undergoing a mitral valve stenosis repair via balloon valvotomy should be put on restrictions for 4 weeks post-procedure,5,6, and can be cleared for full duty when they have met all the following criteria post procedure:

  • Asymptomatic (e.g., no symptoms of reduced cardiac output, no signs of arterial emboli, etc.)
  • ECG with normal sinus rhythm
  • EST to at least 12 METS with normal findings
  • Baseline (1-3 months post procedure) echocardiogram meeting Stage A or Stage B criteria (Table 1)1
  • Off all anticoagulant medications

Post Commissurotomy: LEOs undergoing a mitral valve commissurotomy should be put on restrictions for 3 months post-procedure,5,6 and can be cleared for full duty when they have met all the following criteria post procedure:

  • Asymptomatic (e.g., no symptoms of reduced cardiac output, no signs of arterial emboli, etc.)
  • ECG with normal sinus rhythm
  • EST to at least 12 METS with normal findings
  • Baseline (1-3 months post procedure) echocardiogram meeting Stage A or Stage B criteria (Table 1)1
  • Off all anticoagulant medications
  • Healed surgical sites

Follow-up Evaluation for Mitral Valve Stenosis Repair: LEOs who have undergone a mitral valve stenosis repair should have an annual evaluation by a cardiologist or other physician knowledgeable in the treatment of cardiac valvular disease. Follow-up echocardiograms should be done annually for transcatheter repairs. For surgical repairs, echocardiograms should be done at 1 year and then every 2-3 years.1 Results of both the physician evaluations and the echocardiograms should be shared with the agency’s medical provider.

Mitral Valve Implants/Replacements: See last section of this chapter.