S.: Some aspects of disordered pulmonary function in mitral stenosis. Ann Intern Med 49: 1294

PATIENTS with mitral stenosis frequently exhibit extensive structural changes in the lungs as a result of that disease.1'2 All components of the pulmonary vascular bed may be affected to variable degrees, and alterations of an edematous and fibrotic nature are commonly observed in the alveolar membrane. The extent to which these pulmonary changes influence the clinical pic-ture in mitral stenosis is not clear. The studies of pulmonary function reported in the literature 3'4 ' 5 » 7»13 show moderate deviations from the normal but have contributed little either to a basic understanding of the disease or to the clinical management of patients. Several observations suggest, however, that the role of the lungs may be a significant one and that further exploration of this phase of mitral stenosis is warranted. Hyperventilation has been observed both at rest and during exercise in patients with mitral stenosis,4'5'6 and recently a cor-relation has been reported between the degree of hyperventilation and th