The mitral valve is
located on the left side of your heart, between two chambers: the atrium
(upper) and the ventricle (lower). Blood is pumped from the left atrium,
through the mitral valve, and into the left ventricle on its way to the aorta.
The healthy mitral valve allows blood to pass through, but prevents it from
Mitral valve stenosis,
also known as mitral stenosis, is when the mitral valve opening is narrowed.
This means that not enough blood can flow through it. This can lead to a variety
of issues, including fatigue, difficulty breathing, blood clots, and heart
Scarring caused by
rheumatic fever is the leading cause of mitral valve stenosis. Although
rheumatic fever is common in some countries, it is has become rare in the
United States due to early recognition and treatment of streptococcal
What Causes Mitral Valve Stenosis?
Mitral valve stenosis is
typically caused by rheumatic fever. This is usually a childhood disease, and
it results from the body’s immune response to an infection with the
streptococcal bacteria. It is a serious complication of strep throat or scarlet
The body’s organs most
affected by the acute rheumatic fever are the joints and the heart. The joints
can become very inflamed and can lead to temporary and sometimes chronic
disability. The lining of the heart (endocarditis), the heart muscle
(myocarditis), and the membrane surrounding the heart (pericarditis) can become
When the mitral valve (or
any of the heart valves) becomes involved, this leads to a chronic heart
condition called rheumatic heart
disease. The clinical signs and symptoms of this condition might not
occur until 5 to 10 years after the episode of rheumatic fever.
According to the American
Heart Association (AHA), most U.S. cases of mitral stenosis are in older adults
who had rheumatic fever before the widespread use of antibiotics. It is also
more likely to occur in people who have moved from countries where rheumatic
fever is common.
The factors that make some
people more susceptible than others to mitral valve stenosis are unclear, but
it is estimated that women are more at risk than men, according to the American Heart Association.
A congenital heart defect
may cause mitral valve stenosis in a baby. Babies born with this condition
usually need surgery, according to medical journal Research in Cardiovascular Medicine.
In rare cases, calcium may
build up and lead to narrowing of the mitral valve. Other, more rare causes for
mitral valve stenosis include:
- blood clots
- radiation treatments
- calcium buildup on valves
- congenital heart defects
What Are the Symptoms of Mitral Valve Stenosis?
Mitral valve stenosis
commonly leads to shortness of breath, especially during exercise or when lying
Other common symptoms
- cough, with or without blood
- chest pain, or chest discomfort
- swelling in ankles and/or feet
- respiratory infections
- plum-colored cheeks
If mitral valve stenosis
is severe, you may feel your heart fluttering or beating rapidly.
Rarely, you may feel
discomfort in your chest. Your chest might feel tight or constricted, or you
may feel pain that radiates outward from your chest.
In some cases, mitral
valve stenosis may not cause any symptoms, or the symptoms may appear only
during exercise. You might develop symptoms when your body undergoes stress such
as during an infection or pregnancy.
In addition to the common
symptoms, children with this issue might experience slower growth.
How Is Mitral Valve Stenosis Diagnosed?
There are several tests
that your doctor may use to diagnose mitral valve stenosis:
Your doctor will listen to
your heart with a stethoscope. In people with this condition, the heart often
makes unusual sounds such as rumbling and snapping. According to the Mayo Clinic, a heart “murmur,” arrhythmia, and fluid in the
lungs are all indicators of mitral valve stenosis.
Your doctor may use a
variety of imaging tests to confirm the diagnosis, as well as to deduce the
original cause of the problem, including:
- Echocardiogram is an image of the heart’s structure and
function produced by ultrasound waves. This is by far the most commonly
used diagnostic test.
- Chest X-ray provides images of heart and lungs.
- Transesophageal echocardiogram (TEE) is an image of the heart produced when a
device that emits ultrasound waves is threaded into your esophagus. This
method creates a more detailed picture than a traditional echo because the
esophagus is right behind the heart.
- Cardiac catheterization is a long, thin tube is inserted into your
arm, upper thigh, or neck, and threaded up to your heart. This allows your
doctor to do a variety of tests, including getting an image of the heart’s
blood vessels. This is the most invasive and risky procedure, but also the
Tests for Heart Rhythm
Tests that can monitor
your heart for rhythm abnormalities include:
- electrocardiogram: a recording of your heart’s electrical
- Holter monitoring: when your heart’s electrical activity is
recorded using a portable monitoring device worn over a period of time (24
to 48 hours usually)
Your doctor may have you perform
moderate aerobic activity, and then monitor you while you exercise to determine
how your heart responds to physical stress.
How Is Mitral Valve Stenosis Treated?
Treatment for mitral valve
stenosis can vary greatly, depending on your symptoms and the severity of the
condition. If you have no symptoms and only mild mitral valve stenosis, you
might not need any treatment.
Drugs and Medication
If your mitral valve
stenosis is causing symptoms, your doctor might prescribe medications. Although
these do not actually fix the problem with your mitral valve, they can help
treat your symptoms. Types of medications your doctor might prescribe include:
- anticoagulants (blood thinners)
- diuretics (to reduce fluid buildup through
increased urine output)
- antiarrhythmics (medications to treat abnormal
- beta-blockers (medications to slow your heart
Your doctor may choose to
perform a mitral balloon valvuloplasty. If you need more treatment than just
medication, but your mitral valve is not damaged enough to require heart surgery,
this procedure is an option. This involves threading a tube (catheter) with a
balloon attached to it through a vein and into your heart. Once in the mitral
valve, the doctor inflates the balloon to expand the valve. In some cases, you
may need to undergo this procedure more than once.
Surgery may become
necessary. Your doctor might be able to surgically repair your existing mitral
valve to make it function properly. If that isn’t possible, you may need to
have your mitral valve replaced with a new one. The replacement might be
biological (from a cow, pig, or human cadaver, for example), or mechanical.
Are Complications That Can Result from Mitral Valve Stenosis?
If undetected or untreated, mitral valve stenosis
can result in serious complications. Most commonly, these clients will develop
arrhythmia (irregular heartbeat). Atrial fibrillation, in which the upper
chambers of the heart tremble, will develop in many cases. If undetected or
untreated, mitral valve stenosis can result in serious complications.
(an infection of the heart) and heart failure can occur.
valve stenosis also affects the lungs. Fluid buildup in the lungs (pulmonary
edema) and pulmonary hypertension may develop as a result of mitral valve
Practices to Improve Outcomes
Although lifestyle changes
cannot repair mitral valve stenosis, they may ease your symptoms or help keep
the problem from worsening.
Your doctor might suggest
that you make changes to your diet. These typically involve consuming less:
- other stimulants (such as cough and cold
You should reach or
maintain a weight that is healthy for you. Your doctor may instruct you to
exercise to help you get or stay fit. However, your exercise regime must take
your condition into account because exercising too vigorously might cause your
symptoms to flare up.