STUDIES IN MITRAL STENOSIS

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Abstract
DIGITALIS substances are usually employed in the treatment of patients with mitral stenosis who display clinical symptoms of either marked dyspnea or peripheral congestion. The clinical responses of these patients to such therapy may be gratifying, but not infrequently the drugs appear to exert no beneficial effect and may even be deleterious. The reasons for such varying responses to this therapeutic measure are poorly understood by most clinicians, who are likely to employ broad generalizations in their attitudes regarding the use of digitalis in mitral stenosis, varying from never giving it to giving it routinely in all cases. The variable response to the drug in mitral stenosis can be understood better on consideration of the fact that the disabilities resulting from rheumatic heart disease with mitral stenosis vary greatly in their physiologic and anatomic nature. The fundamental lesion in mitral stenosis is a narrowing of the mitral orifice, resulting in

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