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Mitral Valve Stenosis

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Mitral valve stenosis is a condition where the mitral valve opening becomes narrow. This prevents blood from flowing through it, leading to a number of health problems. Let us learn more about mitral valve stenosis in the following paragraphs.

What is Mitral Valve Stenosis?

The mitral valve consists of the anterior, posterior and annulus leaflets as well as the chordae. The chordae helps the leaflets attach to their papillary muscles. When the valve is functioning normally, it allows the blood from the left atrium flow into the left ventricle. This happens during the diastole and regurgitation during systole is prevented due to the valve closure. The entire mitral valve function, thus, depends not just on the valvular structure, but also the adjacent wall of the myocardium.

In case of mitral valve stenosis, the mitral valve does not open wide enough. It becomes narrow, due to stiffness or scarring or in some cases, the leaflets partially fuse together.

This reduces the blood flow through the valve causing back pressure build-up behind the affected valve. This leads to many health problems such as fatigue, blood clots and even heart failure.

The most common cause of mitral valve stenosis is rheumatic fever. When left untreated, it can cause serious health complications.

Symptoms of Mitral Valve Stenosis

Patients are usually in the age group of 30s to 50s when they first exhibit the symptoms. At times, the symptoms may even appear during childhood. The symptoms exhibited by a patient with mitral valve stenosis are as follows:

  • Heart failure
  • Heart palpitations
  • Chest pain
  • Thromboembolism
  • Dizziness or fainting
  • Hemoptysis or blood-tinged sputum coughed up after heavy coughing
  • Severe headache
  • Symptoms of stroke, such as speech problems
  • Ascites
  • Edema
  • Hepatomegaly

The last three symptoms listed appear when right-side heart failure develops. Pregnant women and people who exercise can also complain of fatigue and weakness.

Causes for Mitral Valve Stenosis

Most of the cases of mitral valve stenosis are due to rheumatic fever. Rheumatic fever often occurs as a serious complication of scarlet fever or strep throat. The rheumatic fever can affect the heart lining or heart muscles as well as the membrane surrounding the heart. These areas become inflamed and can lead to rheumatic heart disease.

Other causes of mitral valve stenosis include:

  • Calcification of mitral valve leaflets
  • Underlying congenital heart disease
  • Infective endocarditis
  • Systemic lupus syndrome
  • Whipple disease
  • Rheumatoid arthritis
  • Fabry disease

Diagnosis of Mitral Valve Stenosis

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During a physical examination, the doctor hears a heart murmur or other abnormal sounds with a stethoscope. He/she may even find a prominent jugular vein in the neck. The lungs may develop congestion due to fluid buildup, a sign of mitral valve stenosis. The liver may develop swelling due to fluid buildup. The doctor may thus suggest the following diagnostic tests:

  • Chest X-ray
  • Echocardiogram
  • Transthoracic echocardiogram
  • Transesophageal echocardiogram
  • Cardiac catheterization

Treatment for Mitral Valve Stenosis

No immediate treatments are planned in case of mild to moderate mitral valve stenosis. The patient will be regularly called for checkups to monitor the condition.

There are no specific medications for mitral valve defect. Medications prescribed help treat the symptoms such as:

  • Anticoagulants
  • Diuretics
  • Antiarrhythmics
  • Beta-blockers

In severe cases, surgery is carried out to repair the valve or replace it, according to the condition. In some cases, a nonsurgical procedure called balloon valvuloplasty is carried out to repair the narrowed valve. However, this procedure is not suitable for all patients. Other surgical options include commissurotomy, a type of open heart surgery to remove calcium deposits and scar tissue. Mitral valve replacement surgery is carried out to replace the valve with a mechanical or tissue valve.

In most cases, mitral valve stenosis is a mild condition and does not lead to any symptoms or complications. However, the symptoms can worsen over the years. There is no way to reverse the narrow mitral valve condition. Surgery proves to improve the situation for patients with severe stenosis. Follow the advice of your doctor related to your condition.

Written by: Saptakee sengupta
Date last updated: April 07, 2015

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