A 58-year-old man with a 10-year history of rheumatic heart disease presents with dyspnea on exertion and orthopnea. On examination, he has an opening snap followed by a mid-diastolic murmur best heard at the apex with the patient in the left lateral decubitus position. Echocardiography confirms mitral stenosis with a valve area of 1.2 cm². Regarding the clinical features and management of mitral stenosis, all of the following are true EXCEPT: