Long-standing severe mitral stenosis usually leads to what condition?

Long-standing severe mitral stenosis often results in congestive heart failure due to the increased pressure within the left atrium and pulmonary circulation. This obstruction at the mitral valve impairs blood flow from the left atrium to the left ventricle during diastole, leading to elevated pressures in the atrium and subsequently in the lungs, which can cause pulmonary congestion.

Over time, this increased pressure can result in various complications, including left atrial enlargement, atrial fibrillation, and further deterioration of cardiac function. The symptoms of congestive heart failure, such as shortness of breath, fatigue, and fluid retention, arise from the heart's inability to effectively pump blood to meet the body’s demands.

In contrast, conditions like aortic regurgitation, myocardial infarction, and coronary artery disease are not directly caused by mitral stenosis. Aortic regurgitation involves a different valve and disease process, myocardial infarction typically arises from coronary artery blockage and ischemia, and coronary artery disease is due to the buildup of plaque in the coronary arteries, independent of mitral valve function. Therefore, congestive heart failure is the most direct and expected outcome of long-standing severe mitral stenosis.