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. Blood must flow from the atrium, through the mitral valve, and into the ventricle before being pumped out into the rest of the body. Mitral stenosis results in inadequate blood flow between the two left chambers, and therefore too little blood and oxygen being pumped throughout the body.
The most common cause of mitral stenosis is
, which scars the mitral valve. A less common cause is a congenital defect, usually part of a complex of multiple heart defects present at birth. Very rare causes include blood clots, tumors, or other growths that block blood flow through the mitral valve.
A risk factor is something that increases your chance of getting a disease or condition. The main risk factor for mitral stenosis is rheumatic fever. Other risk factors include:
Age: 30 to 50
Symptoms may include:
Difficulty breathing, especially during exercise and when lying flat
Awakening short of breath in the middle of the night
Chest pain, such as squeezing, pressure, or tightness (rare)
Sensation of rapid or irregular heartbeat (palpitations)
Cough with exertion
Coughing up blood
Swelling of the legs or feet
Frequent respiratory infections
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:
—a test that uses radiation to take pictures of structures inside the chest
(ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
—a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart; in this test, the sound waves are passed through a transducer that is placed onto your chest.
Transesophageal echocardiogram—uses the same ultrasound techniques to create an image of your heart, but gives a more detailed image. In this test, the transducer is passed down your esophagus (the tube in your throat that runs from your mouth into your stomach), to allow a better examination of the mitral valve.
Holter monitor—a portable EKG device that you wear for 24 or more hours, to detect heart rhythm abnormalities that often accompany mitral stenosis
If you have mitral stenosis, you will need antibiotics when you have certain infections (eg, beta-strep infections, usually of the throat) or are having procedures (such as dental work) that may put you at risk for heart infections. This will help prevent further damage to your heart.
If you have mild mitral stenosis, your condition will need to be monitored, but may not need immediate treatment for symptoms associated with mitral stenosis. When symptoms become more severe, you may need to limit exertion and avoid high-salt foods. In addition, treatments may include:
Drugs may be prescribed to treat specific symptoms associated with mitral stenosis. These medications include:
Drugs that lower the heart rate and improve the heart's function (beta-blockers and calcium channel blockers)
Water pills (diuretics)
Blood-thinning drugs—Mitral stenosis can lead to blood clots that can go to the brain, causing
, or to the limbs, causing severe problems.
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.
If you are diagnosed with mitral stenosis, follow your doctor's
Most cases of mitral stenosis can be prevented by preventing rheumatic fever:
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a