The main etiology of mitral stenosis is rheumatic fever. There remains a significant problem in developing countries and persists also in developed countries despite a marked decline in prevalence in recent decades. It mainly affects young adults, however it changes clinical presentation in older patients with more altered valvular anatomy. The objective of this work is to analyse the particularity of the mitral stenosis in Moroccan elderly over 45 years.

This is a descriptive and analytical study, conducted in Ibn-Rochd Center of Cardiology from January 2014 to November 2018, which included 116patients with a sever mitral stenosis, divided into 2 groups: Group I 132 patients <45 years, group II 124patients>45years.

In our series, there was a female predominance in the 2groups (68% group I vs. 71% group II). In patients over 45years, the atrial fibrillation was more common (83%), left atrium was more dilated, the valves were more calcified (84% vs. 73,33%), and the average gradient was higher (44,64% vs. 30%). The history percutaneous mitral dilatation was more frequent in group II (33%). 3% of the patients in the second group had a thrombus of left atrium.

The mitral stenosis in elderly subjects has more impact on the cardiac arrhythmia, the size of the LA, thrombo-embolisme complications, the severity of the gradient, and on valvular anatomy that is more calcified.