Which symptom is often associated with severe manifest symptoms of mitral stenosis?

Mitral stenosis is characterized by the narrowing of the mitral valve opening, which restricts blood flow from the left atrium to the left ventricle during diastole. As a result, this can lead to a range of symptoms due to increased pulmonary pressure and subsequent right heart failure. Among the symptoms associated with moderate to severe mitral stenosis, ascites is notably significant.

Ascites is the accumulation of fluid in the abdominal cavity, which can occur due to the elevated pressures in the venous system that are a direct result of left atrial enlargement and pulmonary congestion. As the condition progresses, patients may experience right-sided heart failure due to the pressure overload, leading to hepatic congestion and eventually fluid accumulation in the abdomen.

The presence of ascites indicates a more advanced state of fluid overload and heart failure, often reflecting the systemic consequences of severe mitral stenosis. This makes it a meaningful symptom in the evaluation of patients with this condition. In contrast, while symptoms like chest pain, syncope, or loss of consciousness can also be present in various cardiovascular conditions, they are not as specifically indicative of the systemic effects of severe mitral stenosis as ascites.