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JAMA. 1954;154(1):49-52. doi:10.1001/jama.1954.02940350051013.
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PHYSICAL SIGN OF TIGHT MITRAL STENOSIS AID IN SELECTION OF PATIENTS FOR VALVULOTOMY  William Dressler, M.D. Morris Kleinfeld, M.D. and Charles B. Ripstein, M.D., New YorkSurgical repair of mitral stenosis has been proved beneficial in suitable subjects. Many patients who have mitral stenosis of moderate degree may engage in normal activities and live a normal life; they do not require surgical treatment. Only those with tight mitral stenosis should be subjected to surgery.1Ravin and associates1b studied 17 patients in whom the diagnosis of tight mitral stenosis was confirmed by surgical exploration. These authors listed right ventricular hypertrophy as one of the significant features of tight mitral stenosis. They pointed out the difficulty that is occasionally encountered in assessing right ventricular hypertrophy by roentgenologic study; they further stressed that electrocardiographic evidence of right ventricular hypertrophy was present only in a minority of their patients.A physical sign


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