Mitral Stenosis

Mitral stenosis is a heart valve disorder that causes the mitral valve opening to narrow or become obstructed. The narrowing of the mitral valve prevents it from properly opening and obstructs blood flow from the left atrium to the left ventricle. This has the potential to reduce the amount of blood that flows forward to the body.

Symptoms of Mitral Stenosis

Mitral valve stenosis typically worsens gradually. You could have no symptoms or only have mild ones for many years. Mitral valve stenosis symptoms can appear at any age, including childhood.

Mitral valve stenosis symptoms include:

Shortness of breath, especially when active or lying down
Fatigue, particularly during periods of increased activity
Foot or leg swelling
Fast, fluttering, or pounding heartbeat sensations
Fainting or dizziness
Heart murmur, or irregular heart sound
Fluid accumulation in the lungs
Heart rhythm irregularities
Coughing up blood because of chest discomfort or pain
Symptoms of mitral valve stenosis may appear or worsen when the heart rate rises, such as during exercise. Anything that stresses the body, such as pregnancy or infections, can cause symptoms.

Causes of Mitral Stenosis

Rheumatic fever. fever. The most typical cause of mitral valve stenosis is this side effect of strep throat. Rheumatic mitral valve disease is the term for the condition that results when rheumatic fever damages the mitral valve. Years or even decades after rheumatic fever, the symptoms of valve disease may not appear.
Calcium deposits. The mitral valve may develop calcium deposits with advancing age. The supporting structures for the mitral valve flaps may become more restricted as a result. MAC, or mitral annular calcification, is the short name for the condition. Mitral stenosis symptoms are brought on by severe MAC. Even with surgery, it’s challenging to treat. People who have calcium around their mitral valve frequently experience issues with their aortic valve as well.
Radiation therapy is a method of treating specific cancers. The mitral valve may occasionally become harder and thicker as a result of chest radiation. Usually, the damage to the heart valves happens 20 to 30 years after radiation therapy.
Congenital heart defect refers to a heart condition that exists from birth. Rarely, some infants are born with a progressively problematic narrowed mitral valve.
Other Health Conditions. Mitral valve stenosis can sporadically be brought on by lupus and other autoimmune diseases.

Complications of Mitral Stenosis

Irregular Heartbeats
Arrhythmias refer to irregular heartbeats.
Atrial fibrillation is a heart rhythm disorder that can be brought on by stenosis of the mitral valve.
AFib is the most popular name for it.
Mitral stenosis frequently leads to AFib as a side effect.
Older age and more severe stenosis increase the risk.
Blood clots.
Blood clots in the heart can form as a result of irregular heartbeats linked to mitral valve stenosis.
A stroke can happen if a heart-related blood clot gets into the brain.
High blood pressure in the arteries that supply the lungs.
Pulmonary hypertension is the term used in medicine to describe this condition. A narrowed mitral valve that slows or obstructs blood flow can cause it. Pressure in the lung arteries increases when blood flow is reduced. To pump blood through the lungs, the heart has to exert more effort.
Right-sided heart failure.
The heart is strained by variations in blood flow and high pressure in the arteries that supply the lungs. To pump blood to the right-sided heart chambers, the heart must exert more effort. The heart muscle eventually deteriorates and fails as a result of the added effort.

Diagnosis of Mitral Stenosis

If you have symptoms of mitral valve stenosis, your heart will be examined with some of the following tests.

A stethoscope is used by the provider to listen to your heart. Because of the narrowed opening, mitral valve stenosis frequently causes an irregular heart sound. This is known as a heart murmur. The stethoscope is also used by the provider to listen to your lungs. Fluid buildup in the lungs can be caused by mitral valve stenosis. This could be referred to as congestion.
Echocardiogram. Mitral stenosis can be confirmed with an echocardiogram. Images of the beating heart are created by sound waves. The test can detect areas of poor blood flow as well as heart valve issues. It can also aid in determining the severity of mitral valve stenosis.
Standard echocardiogram, also known as a transthoracic echocardiogram, uses a wand-like device called a transducer to direct sound waves at the heart. The device is firmly pressed against the skin on the chest.
Another type of echocardiogram may be performed if more detailed images are required. This is known as a transesophageal echocardiogram. A wand-like device attached to the end of a tube is inserted down the throat and esophagus, closer to the heart and thus providing more detailed imaging of the heart structures. For this type of echocardiogram, the throat is numbed. If you have severe mitral stenosis, you should have an echocardiogram every year. Echocardiograms are recommended every 3 to 5 years for people with less severe mitral stenosis. Inquire with your provider about how frequently you’ll require one.
Electrocardiogram. This quick and painless test, also known as an ECG or EKG, measures the electrical activity of the heart. Electrodes, which are sticky patches, are applied to the chest and, in some cases, the arms and legs. The electrodes are linked by wires to a computer, which displays the results. An ECG shows how fast or slow the heart is beating. A health care provider can look for signal patterns to see if there is an irregular heartbeat.
X-ray of the lungs. A chest X-ray reveals the condition of the heart and lungs. It can detect whether the heart is enlarged, which can be a sign of certain types of heart valve disease.
Exercise Stress Tests. These tests frequently involve walking on a treadmill or riding a stationary bike while the heart rate is monitored. Exercise tests can reveal how the heart responds to physical activity and whether symptoms of valve disease occur during exercise. If you are unable to exercise, you may be given medications that mimic the effect of exercise on your heart.
CT scan of the heart. This examination combines several X-ray images to provide a more detailed cross-sectional view of the heart and its valves. A cardiac CT scan is commonly used to assess mitral stenosis that is not caused by rheumatic fever.
MRI scan of the heart. This test creates detailed images of the heart using magnetic fields and radio waves. To determine the severity of mitral valve stenosis, a cardiac MRI may be performed.
Catheterization of the heart. This test isn’t commonly used to diagnose mitral stenosis, but it may be used if other tests fail to diagnose or determine the severity of the condition. A catheter is a long, thin, flexible tube that is inserted into a blood vessel, usually in the groin or wrist. It is directed to the heart. Dye is delivered to arteries in the heart via the catheter. The dye makes the arteries more visible on X-ray images and video.

The results of your tests can help your doctor plan the best treatment for you.

Treatment of Mitral Stenosis

Among the possible treatments are:

Medication: Mitral stenosis can be treated with a variety of medications. Some of the medicines used include those for high blood pressure, heart failure symptoms (particularly swelling from too much fluid), managing fast heart rhythms, and blood thinners (to prevent stroke). Your doctor may also recommend a long-term course of antibiotics to protect your heart valves.
Catheter-based techniques. These gain access to your heart from within your body by inserting a device into another artery. After that, the catheter is threaded up to your heart and used to repair or replace the valve.
Balloon valvotomy: This procedure, also known as valvuloplasty, uses a catheter with a balloon attached. Inflating the balloon once it reaches your mitral valve can widen the narrowed area.
Valve replacement: In some cases, a catheter-based procedure can be used to replace a valve. This is known as transcatheter mitral valve replacement (TMVR).
Surgery: A surgeon can use a variety of techniques, such as minimally invasive surgery or robotically assisted surgery. Depending on your situation and needs, your surgeon may recommend either repairing or replacing the valve.