Protocolo diagnóstico y terapéutico de la valvulopatía mitral en el anciano

Abstract

Mitral valve disease in older adults presents diagnostic and therapeutic challenges due to comorbidities and physiological changes associated with age. Mitral stenosis, mostly of rheumatic origin, and degenerative or functional mitral insufficiency are the predominant forms. Typical symptoms include dyspnea, fatigue, and arrhythmias such as atrial fibrillation that are aggravated by decreased cardiac reserve in older patients. The diagnostic protocol entails a detailed anamnesis, clinical examination, and echocardiographic studies, with three-dimensional echocardiography and catheterization being useful in complex cases. Therapeutic strategies depend on disease severity, the patient's functional status, and comorbidities. Medical treatment seeks to alleviate symptoms through diuretics and heart rhythm control. Surgical interventions, such as valve replacement or repair, and percutaneous procedures, such as mitral valvuloplasty, are carefully considered options in this group of patients. A multidisciplinary assessment and individualized management are essential in order to optimize clinical outcomes, improving quality of life and reducing complications in this vulnerable population.