Mitral valve disease is usually a mixed pattern of stenosis and incompetence, one of which usually predominates. Both stenosis and incompetence lead to a poorly functioning valve and subsequent heart changes, which include: left ventricular hypertrophy (this is appreciably less marked in patients with mitral stenosis); increased pulmonary venous pressure; pulmonary edema; and enlargement (dilation) and hypertrophy of the left atrium.