Mitral Stenosis

Basic Facts

  • The mitral valve separates the top and bottom chambers of the left side of the heart, the left atrium and left ventricle.
  • In mitral stenosis (MS), the mitral valve opening is narrowed. This can cause blood to back up in the left atrium, in the blood vessels in the lungs, and ultimately into the right side of the heart. 
  • Typically occurs gradually over time.
  • May eventually lead to valve repair or replacement surgery.  

There are often no symptoms for mitral stenosis until the valve narrowing is more severe, because mitral stenosis usually advances slowly over years, giving the body time to adjust.  

As it advances to severe, it can lead to shortness of breath, severe cough, hemoptysis (coughing up blood), swelling in the legs, and other symptoms of CHF.  

It is also associated with atrial fibrillation and forming blood clots in the heart. 

  • Most commonly secondary to rheumatic heart disease (due to a prior infection inside the heart), but this is now rare in the USA.
  • Mitral annular calcification is a hardening/thickening of the base of the mitral valve, common in older adults, which may occasionally progress to cause a degree of Mitral Stenosis.
  • Radiation therapy (used to treat cancer) may be associated with valvular heart disease, if the cancer (and therefore the radiation beam) was located near the heart.
  • Rarely congenital, meaning due to a defect present at birth, and these defects are noted as an infant or child. 

 

 

Your healthcare provider may hear a murmur in your chest with their stethoscope. In mitral regurgitation, this murmur is caused by the sound of blood “whooshing” through the leaky mitral valve. Other tests may include: 

  • ECG – measures the electrical activity of the heart, regularity of heartbeats, and screens for thickening of the heart muscle (hypertrophy) and/or heart-muscle damage. 
  • Echocardiogram – painless, noninvasive study that uses ultrasound waves to evaluate heart structure & function, including the heart valves, in real time.  
  • Cardiac catheterization - threading a small tube (catheter) up a blood vessel into the heart chambers to measure pressures across the valve and to inject dye during a moving X-ray to detect/measure the regurgitation. 
  • Follow prevention tips for a heart healthy lifestyle. 
  • Control blood pressure, as high pressure increases wear and tear on the valve over time. 
  • Mild to moderate Mitral Stenosis is followed with a “watch and wait” approach, with a visit and/or echo every 1-2 years.
  • If pregnant, there is a direct relationship between the severity of MS and the risk of maternal and/or fetal complications.
  • Most with Mitral Stenosis will need to take antibiotics prior to dental visits, because it is most commonly due to prior infection in the heart. Antibiotics are also recommended if surgery was performed on the mitral valve.