Mitral Stenosis

Mitral Stenosis is a narrowing of the mitral valve in the heart. This valve is located between the atrium (upper chamber) and the ventricle (lower pumping chamber) of the left side of the heart. The mitral valve has two cusps, or flaps, that control the direction and flow of blood. Mitral stenosis results in inadequate blood flow between the two left chambers.

Causes

The most common cause of Mitral Stenosis is rheumatic fever, which scars the mitral valve. A less common cause is a congenital defect.

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition. The main risk factor for Mitral Stenosis is rheumatic fever. Other risk factors include:
  • Sex: Female
  • Age: 30 - 50

Symptoms

Symptoms may include:
  • Difficulty breathing
  • Fatigue
  • Chest pain, such as squeezing, pressure, or tightness
  • Sensation of rapid or irregular heartbeat (palpitations)
  • Cough with exertion
  • Coughing up blood
  • Swelling of the legs or feet
  • Frequent respiratory infections

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor may be alerted to Mitral Stenosis by the following:
  • Abnormal chest sounds, such as a heart murmur or snap
  • Distention of the jugular vein in the neck
  • Signs of fluid in the lungs
Tests may include:
  • Chest x-ray – a test that uses radiation to take pictures of structures inside the chest
  • Electrocardiogram (ECG, EKG) – a test that records the heart's activity by measuring electrical currents through the heart muscle
  • Echocardiogram – a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
  • Cardiac catheterization – an x-ray of the heart's circulation that is done after injection of a contrast dye

Treatment

If you have mild Mitral Stenosis, your condition will need to be monitored, but may not need immediate treatment. When symptoms become more severe, treatments may include:
Medications
Drugs may be prescribed to treat specific symptoms associated with Mitral Stenosis. These medications include:
  • Drugs to control heart arrhythmias
  • Blood-thinning drugs
  • Diuretics
  • Beta-blockers
  • Calcium channel blockers
Surgery
Common types of heart valve surgery include: Mitral Valvulotomy – A surgical cut or enlargement is made in the stenotic mitral valve to relieve the obstruction.
Balloon Valvuloplasty – A balloon device is inserted into the blocked mitral valve to open or enlarge the valve. This may provide temporary relief of symptoms. However, the valve may become blocked again.
Mitral Valve Replacement –This is the surgical replacement of a defective heart valve. This surgery is usually delayed until symptoms are severe or the patient can no longer be helped by other procedures.

Prevention

Mitral Stenosis cannot be prevented. But, there are several things you can do to try to avoid some of the complications:
  • Get regular medical care, including checkups and periodic electrocardiograms.
  • Take antibiotics before any dental cleaning, dental work, or other invasive procedures. This will help prevent infection of the heart valve.
  • Treat strep throat infections promptly to avoid rheumatic fever, which can cause scarring of the heart valve.
  • If your valve problem was caused by rheumatic fever, talk to your doctor about antibiotic treatment to prevent future episodes of rheumatic fever.