Overview

What is mitral valve stenosis?
Mitral valve stenosis is a heart condition in which the
mitral valve fails to open as wide as it should.
Although it has no immediate effect on health, eventually mitral valve stenosis
can cause irregular heartbeats and possibly
heart failure or other complications, including
stroke, heart infection,
pulmonary edema, and blood clots.
See an illustration of an
open and
closed mitral valve
.
What is the purpose of the mitral valve?
The mitral valve is one of four valves in the heart. It regulates
blood flow from the
left
atrium
into the
left ventricle, the heart's main pumping chamber. A
normal mitral valve has two flaps, or leaflets. When the heart pumps, blood
forces the flaps open, and blood flows from the left atrium (upper chamber) to
the left ventricle (lower chamber). Between heartbeats, the leaflets close
tightly so that blood does not leak backwards through the valve.
However, with mitral valve stenosis, the two leaflets and related
structures become stiff, scarred, or partially fused together. As a result, the
mitral valve gradually narrows, restricting blood flow to the left ventricle,
increasing the volume and pressure of blood in the left atrium, and causing
blood to back up into the lungs.
See an illustration of the
heart and
its chambers, valves, and blood flow
.
See an illustration of
mitral
valve stenosis
.
What causes mitral valve stenosis?
Virtually all cases of mitral valve stenosis are caused by
rheumatic fever, which can follow an untreated
strep throat infection. However, many people who have
mitral valve stenosis don't realize they had rheumatic fever.1
What are the symptoms?
Although mitral valve stenosis is a lifelong disease, symptoms
usually do not develop for 10 to 20 years and may take as long as 40
years.1, 2 Early symptoms, such
as shortness of breath with exertion, are often mild and hard to distinguish
from normal breathing during exercise. Symptoms may not be noticeably abnormal
until late in the disease.
In the later stages of mitral valve stenosis, the left atrium may
not be able to keep pumping the same volume of blood into the left ventricle.
Blood will begin to back up into the lungs, causing symptoms such as shortness
of breath at rest or with only mild-to-moderate exertion, fatigue, weakness,
and pounding of the heart.
How is mitral valve stenosis diagnosed?
Because early symptoms may be mild or unnoticeable, mitral valve
stenosis may not be diagnosed in its early stages.
A review of your medical history and a physical examination will
help your doctor determine how seriously your mitral valve is affected. To help
check it, your doctor may order one or more of the following tests:
- An
electrocardiogram, a test that measures the electrical
signals that control the rhythm of your heartbeat
- An
echocardiogram, which is an ultrasound examination
used to study the heart
- A chest
X-ray
How is it treated?
You and your doctor will need to decide whether to monitor the
condition of your valve or fix it immediately. If you have stable mitral valve
stenosis, or if you have no symptoms or mild symptoms, your doctor will likely
monitor the progress of the stenosis and try to prevent complications in your
heart or lungs.
If you have severe mitral valve stenosis or extensive heart
damage that will likely get worse, your doctor will probably advise you to fix
the valve, either with a balloon valvotomy, which stretches the valve open, or
by having surgery to repair or replace the valve.
Your doctor may also prescribe medications to reduce symptoms or
treat underlying or related conditions, such as
abnormal heartbeats, blood clots, or heart failure.