Mitral Stenosis

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What is mitral stenosis?

Mitral stenosis refers to a narrowing or obstruction of the mitral valve. This narrowing or obstruction prevents the valve from opening properly. Blood flow between the left atrium and the left ventricle is restricted by this obstruction, which can reduce the amount of blood supply to the body. The atrium also enlarges as pressure builds, and blood can backflow into the lungs, resulting in pulmonary edema (fluid in the lungs).

What causes mitral stenosis?

Mitral stenosis occurs most commonly in people who have had rheumatic fever, which can cause damage to heart valves. Mitral stenosis can be caused by other conditions that affect the mitral valve as well. People with a family history of rheumatic fever are at increased risk for mitral stenosis.

Can mitral stenosis be prevented?

The disorder cannot be prevented, but its complications can. Your doctor may prescribe antibiotic therapy for you prior to any medical or dental procedures that could introduce an infective agent. This includes something as simple as getting your teeth cleaned. Treat strep infections promptly to prevent rheumatic fever. Tell your health care provider if you have a family history of congenital heart diseases.

What are the symptoms of mitral stenosis?

Sometimes no symptoms are present. Symptoms may appear or worsen with exercise, and can include:

• difficulty breathing
• cough
• blood in the sputum (hemoptysis)
• fatigue
• frequent respiratory infections (such as bronchitis)
• chest pain radiating to arm, neck, jaw
• sensation of feeling the heart beat (palpitations)
• swelling of feet or ankles

How is mitral stenosis diagnosed?

Your doctor will take your history, and perform a physical exam. He/she will listen to your heart with a stethoscope for evidence of a murmur or other abnormal heart sound.

Your doctor might also listen to your lungs for evidence of congestion
Certain diagnostic tests and/or imaging methods can be useful in diagnosing mitral stenosis.

They include:

• echocardiogram
• Doppler ultrasound
• chest X-ray
• ECG
• coronary angiography
• Swan-Ganz (right heart catheterization)
• nuclear ventriculography (MUGA or RNV)

How is mitral stenosis treated?

If symptoms are mild or non-existent, no treatment may be necessary. If symptoms are severe, hospitalization may be necessary.

Medications are often used to treat mitral stenosis. They include: diuretics, digoxin, anticoagulants, and antiarrhythmics.

Surgery may be required in some cases to repair or replace the damaged valve. Balloon valvuloplasty (using a balloon attached to a catheter to dilate the area of the valve) may be an option.