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Mitral stenosis Causes and Risks:
Mitral stenosis is a heart valve disorder that affects about 2 out of 10,000 people. Symptoms usually develop between the ages of 20 and 50. It most commonly occurs in people who have had rheumatic fever but can be caused by any disorder that causes narrowing of the mitral valve. Congenital mitral stenosis alone is rare. It more commonly occurs with complex groups of cardiac abnormalities.
Narrowing of the mitral valve obstructs blood flow from the left atrium to the left ventricle. This can reduce the amount of blood that flows forward to the body. The atrium enlarges as pressure builds up in it, and blood may backflow into the lungs resulting in pulmonary edema (fluid in the lung tissue).
Risk factors include a history of rheumatic fever, stroke , or certain other disorders. Symptoms may begin with an episode of atrial fibrillation , or may be triggered by pregnancy or other stress on the body such as respiratory infection, endocarditis , and other cardiac disorders.
Prevention:
Mitral stenosis cannot be prevented but complications can be: note any history of heart valve disease before treatment by a health care provider or dentist. (Any dental work, including cleaning, and any invasive procedure can introduce bacteria into the bloodstream. This bacteria can infect a damaged mitral valve!) Preventive antibiotics before these procedures decrease the risk for endocarditis .
Follow treatment recommended for conditions that may cause valve disease. Treat strep infections promptly to prevent rheumatic fever . Tell your health care provider if you have a family history of congenital heart diseases .
Symptoms:
Note: There are often no symptoms, or symptoms may appear or worsen with exercise or increase in heart rate :
Signs and Tests:
A stethoscope examination reveals a distinctive murmur, snap, or other abnormal heart sound. (The typical murmur is described as a rumbling apical diastolic murmur with pre-systolic accentuation. This means a rumbling sound is heard over the point of the heart during the resting phase of the heart beat, and it gets more pronounced just before the heart contraction begins).
Examination may also reveal irregular heartbeat or lung congestion. Blood pressure is usually normal. There may be vibration (thrill), or a tapping sensation may be noted on palpation over the heart. Mitral stenosis may be difficult to distinguish from left atrial myxoma (a tumor of the heart).
Narrowing or obstruction of the valve, or enlargement of the atrium may show on: This disease may also alter the results of the following tests:
Treatment:
No treatment may be necessary if symptoms are absent or mild. Hospitalization may be required for diagnosis and for treatment of severe symptoms. Medications include diuretics, digoxin, or antiarrhythmics. Anticoagulants may be used to prevent blood clots . Heart valve surgery (mitral commissurotomy) or replacement of the valve may be necessary. Balloon valvuloplasty may be considered instead of surgery.
Prognosis:
The outcome varies. The disorder may be mild or without symptoms. It may be more severe and eventually disabling. Complications may be severe or life threatening. Mitral stenosis is usually controllable with treatment, and improved with surgery.
Complications:
Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms are suggestive of mitral stenosis.
Call your health care provider if you have mitral stenosis and symptoms do not improve with treatment, or if new symptoms appear.
This is a cross-sectional view of the interior of the heart. The valves, chambers, and associated vessels are labeled.
This is an illustration of the exterior of the heart. The arteries are colored blue and represent blood that is flowing into the heart. The veins are red and indicate blood flow out from the heart. The chambers are also labeled.
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