Description

Mitral valve stenosis — sometimes called mitral stenosis — is a narrowing of the valve between the two chambers of the left heart. The narrowing of the valve reduces or blocks the flow of blood in the lower left part of the heart of the camera. The lower left chamber of the heart is the heart's main pumping chamber. It is also called the left ventricle.

Mitral valve stenosis can make you tired and short of breath. Other symptoms may include uneven heartbeats, dizziness, chest pain or coughing up blood. Some people don't notice the symptoms.

Mitral valve stenosis can be caused by a complication of strep throat is called rheumatic fever. Rheumatic fever is now rare in the united States.

The treatment for mitral valve stenosis may include medications or mitral valve repair or replacement surgery. Some people just need regular medical checkups. The treatment depends on the severity of the valve disease and if it is getting worse. This is not, mitral valve stenosis can lead to serious heart complications.

Symptoms

Stenosis of the Mitral valve usually gets worse slowly. You may not have any symptoms, or you may have mild for many years. The symptoms of mitral valve stenosis can occur at any age, even during childhood.

The symptoms of mitral valve stenosis include:

  • Shortness of breath, especially with activity or when lying down.
  • Fatigue, especially during increased activity.
  • Swelling of the feet or legs.
  • Strong, jumping or otherwise, irregular heartbeats, called arrhythmias.
  • Dizziness or fainting.
  • The accumulation of fluid in the lungs.
  • Chest discomfort or pain in the chest.
  • Coughing up blood.

Mitral valve stenosis symptoms may appear or worsen when the heart rate increases, such as during exercise. Anything that puts stress on the body, including the pregnancy or infections, may trigger symptoms.

When to see a doctor

Make an appointment with your health care professional right away if you have chest pain, rapid, fluttering or pounding heart, or shortness of breath during the activity. Your health care professional may tell you to consult a physician trained in diseases of the heart, called a cardiologist.

If you have been diagnosed with stenosis of the mitral valve, but I have not had symptoms, talk to your health care team how often follow-up examinations.

Causes

To understand the causes of the disease of the mitral valve, can be useful to know how the heart works.

The mitral valve is one of the four heart valves that keep blood flowing in the right direction. Each valve has flaps called leaflets that open and close once during each heartbeat. If a valve does not open or close properly, less blood can flow through the heart to the rest of the body.

Stenosis of the mitral valve, the valve opening is narrowed. The heart must work harder to push blood through the small opening of the valve. The flow of blood between the left upper and lower chambers of the heart may decrease.

Causes of mitral valve stenosis include:

  • Rheumatic fever. This complication of strep throat is the most common cause of mitral valve stenosis. When the fever rheumatic damage to the mitral valve, the condition is called rheumatic disease of the mitral valve. Symptoms may not be seen until years or decades after rheumatic fever.
  • The calcium deposits. With age, calcium deposits can build up around the mitral valve. This can cause narrowing of the support structures of the mitral valve flaps. The condition is called calcification of the mitral annular, or MAC for short. Serious MAC can cause the symptoms of mitral stenosis. It is difficult to treat even with surgery. People with calcium around the mitral valve often have similar problems with the heart's aortic valve.
  • The radiation therapy. This is a treatment for certain types of cancer. The radiation in the chest area, it can sometimes cause the mitral valve to thicken and harden. The heart valve damage occurs, typically 20 to 30 years after radiation therapy.
  • Condition of the heart that are present at birth is called a congenital defect of the heart. Rarely, some babies are born with a narrowing of the mitral valve.
  • Other health conditions. Lupus and other autoimmune diseases rarely, it can cause stenosis of the mitral valve.

Risk factors

Risk factors for mitral valve stenosis include:

  • Untreated strep infections. A history of strep throat is not treated or rheumatic fever, increases the risk of stenosis of the mitral valve. However, rheumatic fever is rare in the united States. But it is still a problem in developing countries.
  • Aging. Older adults are at increased risk of calcium buildup around the mitral valve.
  • The radiation therapy. The radiation causes changes in the mitral valve, the shape and structure. Rarely, people who receive radiation therapy to the chest area for certain types of cancer can develop stenosis of the mitral valve.
  • The use of illicit drugs. MDMA, short for methylenedioxymethamphetamine and is commonly called molly or ecstasy, increases the risk of disease of the mitral valve.
  • Use of certain medications. Some medications for migraine headaches, have an ingredient called ergot alkaloids. Ergotamine (Ergomar) is an example. Ergot alkaloids may rarely cause heart valve scarring that leads to mitral stenosis. Greatest weight loss medications containing fenfluramine or dexfenfluramine are also linked to heart valve disease and other heart problems. Fen-phen is an example. No longer sold in the united States.

Complications

Stenosis of the Mitral valve that is not treated can lead to complications such as:

  • Irregular heart beats. Irregular heartbeats are called arrhythmias. Stenosis of the Mitral valve can cause an irregular and chaotic heart rhythm called atrial fibrillation. It is commonly known as atrial fibrillation. Atrial fibrillation is a common complication of mitral stenosis. The risk increases with age and with more severe stenosis.
  • The blood clots. Irregular heartbeat linked to stenosis of the mitral valve can cause blood clots to form in the heart. If a clot of blood from the heart travels to the brain, a stroke can occur.
  • High blood pressure in the arteries of the lung. The medical name for this condition is pulmonary hypertension. This can happen if a narrowing of the mitral valve lessens or blocks the flow of blood. Decreased blood flow increases the pressure in the arteries of the lung. The heart must work harder to pump blood through the lungs.
  • Right-sided heart failure. Changes in the blood flow and the pressure in the arteries of the lung put a strain on the heart. The heart must work harder to pump blood to the chambers on the right side of the heart. The additional effort that eventually causes the heart muscle to become weak and not.

Prevention

Rheumatic fever is the most common cause of mitral valve stenosis. So the best way to prevent stenosis of the mitral valve is to prevent rheumatic fever. You can do this by making sure that you and your kids to see a health care professional for a sore throat. Untreated strep throat infections can develop into rheumatic fever. Strep throat is easily treated with antibiotics.

Diagnosis

For the diagnosis of mitral valve stenosis, your healthcare provider will examine you and ask questions about your symptoms and medical history. You may also ask about your family's medical history.

The healthcare provider listens to your heart and lungs with a device called a stethoscope. Mitral valve stenosis often causes an irregular heart sound due to the narrow opening. This sound is called a murmur in the heart. Stenosis of the Mitral valve can also cause a buildup of fluid in the lungs.

If you have symptoms of mitral valve stenosis, tests are carried out to examine the heart.

Tests

Imaging tests are done to check the health of your heart. Some can confirm stenosis of the mitral valve and to help find the cause. Test results help you decide the treatment.

Tests may include:

  • The echocardiogram.An echocardiogram can confirm the mitral stenosis. Sound waves create images of the beating heart. The test can show areas of poor circulation of the blood and in the heart of the valve changes. It can also help determine the severity of the stenosis of the mitral valve. If you have very severe mitral stenosis, you should obtain an echocardiogram every year. Those with less severe mitral stenosis need an echocardiogram every 3 to 5 years. Ask your healthcare provider how often you need to.
  • Electrocardiogram (ECG or EKG). This quick and painless test shows how the heart is beating. Adhesive patches with sensors go in the chest and sometimes the arms and legs. The wires connect the electrodes to a computer, which displays or prints the results of the test.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. You can determine if the heart is enlarged, which may be a sign of certain types of heart valve disease.
  • The stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the activity of the heart is activated. Exercise tests help to show how the heart responds to physical activity, and if the valve symptoms of the disease occur during the exercise. If you are unable to do exercise, you could get drugs that affect the heart as the exercise you do.
  • CardiacCT. This test combines multiple X-ray images for a detailed view of the heart and the heart valves. A cardiac ct is commonly done to see mitral stenosis, which is not caused by rheumatic fever.
  • CardiacMRI. This test uses magnetic fields and radio waves to create detailed pictures of the heart. A cardiac mri could be done to determine the severity of the stenosis of the mitral valve.
  • The cardiac catheterization. This test is not often used for the diagnosis of mitral stenosis, but it can be done when other tests are not able to diagnose the condition and determine its severity. A flexible tube called a catheter is inserted into a blood vessel, usually in the groin or wrist. Is guided into the heart. Contrast dye flows through the catheter into the arteries in the heart. The dye helps the arteries to show up more clearly on X-ray images and video.

The echocardiogram. An echocardiogram can confirm the mitral stenosis. Sound waves create images of the beating heart. The test can show areas of poor circulation of the blood and in the heart of the valve changes. It can also help determine the severity of the stenosis of the mitral valve.

If you have very severe mitral stenosis, you should obtain an echocardiogram every year. Those with less severe mitral stenosis need an echocardiogram every 3 to 5 years. Ask your healthcare provider how often you need to.

Assay

After the test confirms a diagnosis of the mitral or other heart valve disease, your health care professional may say that the stage of the disease. Staging helps to determine the most appropriate treatment.

The stage of heart valve disease depends on many things, including symptoms, severity of the disease, the structure of the valve or valves and the flow of blood through the heart and lungs.

Heart valve disease is staged in four basic groups:

  • Stage A: At risk. Risk factors for heart valve disease are present.
  • Stage B: Progressive. Valve disease is mild or moderate. No valve of the heart of the symptoms.
  • C-stage: Asymptomatic severe. No valve of the heart of the symptoms, but the disease of the valve is severe.
  • Stage D: Symptomatic severe. Heart valve disease is severe and is causing the symptoms.

Treatment

The treatment for mitral valve stenosis may include:

  • Of medicine.
  • Valve repair or replacement surgery.
  • Open-heart surgery.

If you have mild to moderate stenosis of the mitral valve with no symptoms, you may not need treatment right away. Instead, you need regular medical checkups to see if it makes your condition worse.

A doctor trained in heart disease usually provides care to people with mitral valve stenosis. This type of doctor is called a cardiologist.

Drugs

Medicines are used to reduce the symptoms of mitral valve stenosis. They may include:

  • Diuretics, also called water pills, to reduce the accumulation of fluid in the lungs or other areas of the body.
  • Blood-thinning medicines, called anticoagulants, to help prevent blood clots if you have an irregular heartbeat called atrial fibrillation (AFib).
  • The Beta-blockers, calcium channel blockers or other medications for the heart to slow the heart rate.
  • Medicines for irregular heart rhythm. These drugs are called anti-arrhythmic agents.
  • Antibiotics to prevent a return of rheumatic fever, if that is what damages the mitral valve.

Surgery or other procedures

A diseased or damaged mitral valve, eventually, you might need to be repaired or replaced, even if you do not have valve disease symptoms. If you need surgery for another disease of the heart, a surgeon can make the repair or mitral valve replacement at the same time as the treatment.

Together, you and your health care team talk about the best treatment for you. Surgeries and procedures for mitral valve stenosis may include:

  • The balloon valvuloplasty.This treatment is performed to repair a mitral valve with a narrow opening. Also called mitral balloon valvotomy mitral percutaneous balloon commissurotomy or percutaneous transvenous mitral commissurotomy. Balloon valvuloplasty using a flexible tube called a catheter and a small balloon. The doctor places the balloon on the tip of the catheter into an artery, usually in the groin area. He has guided the mitral valve. The balloon is inflated, expanding the opening of the mitral valve. The balloon is deflated. Then the catheter and balloon are removed. The valvuloplasty could be done even if you have no symptoms. But not all people with mitral valve stenosis is a candidate for treatment. Ask your health care professional if that is an option for you.
  • Open-heart surgery to repair the valve. If a catheter procedure is not an option, open-heart surgery called open valvotomy can be done. The surgery can also be called surgical commissurotomy. Remove any deposits of calcium and other scar tissue blocking the opening of the mitral valve. The heart must be stopped to prevent bleeding in the chest area during this surgery. A heart-lung machine temporarily on the heart of the work. The procedure can be repeated if the stenosis of the mitral valve returns.
  • Replacement of the Mitral valve.If the mitral valve is not repairable, you can perform a surgery to replace the damaged valve. The damaged valve is replaced with a mechanical or valve of a cow, pig or human heart tissue. A valve made from animal or human tissue is called a biological tissue valve. Biological tissue valves will break down over time and may need to be replaced. People with mechanical valves need lifelong blood thinners to prevent the formation of blood clots. Together, you and your healthcare provider should discuss the benefits and risks of each type of valve to make the best choice for you.

The balloon valvuloplasty. This treatment is performed to repair a mitral valve with a narrow opening. Also called mitral balloon valvotomy mitral percutaneous balloon commissurotomy or percutaneous transvenous mitral commissurotomy.

Balloon valvuloplasty using a flexible tube called a catheter and a small balloon. The doctor places the balloon on the tip of the catheter into an artery, usually in the groin area. He has guided the mitral valve. The balloon is inflated, expanding the opening of the mitral valve. The balloon is deflated. Then the catheter and balloon are removed.

The valvuloplasty could be done even if you have no symptoms. But not all people with mitral valve stenosis is a candidate for treatment. Ask your health care professional if that is an option for you.

Replacement of the Mitral valve. If the mitral valve is not repairable, you can perform a surgery to replace the damaged valve. The damaged valve is replaced with a mechanical or valve of a cow, pig or human heart tissue. A valve made from animal or human tissue is called a biological tissue valve.

Biological tissue valves will break down over time and may need to be replaced. People with mechanical valves need lifelong blood thinners to prevent the formation of blood clots. Together, you and your healthcare provider should discuss the benefits and risks of each type of valve to make the best choice for you.

The prognosis for people who have a catheter for treatment or surgery for mitral stenosis is usually good. But, older age, poor health, and a large amount of calcium accumulating in or around the tubes, increase the risk of complications of the surgery. Long-term pulmonary hypertension may worsen the prognosis after valve surgery.

Lifestyle and home remedies

Lifestyle changes can help improve the health of the heart. If you have mitral valve stenosis, try these steps to keep your heart healthy:

  • Eating nutritious food. Eat a variety of fruits and vegetables, low-fat or non-fat dairy products, poultry, fish and whole grains. Avoid saturated and trans fats. Use less salt and sugar.
  • Maintain a healthy weight. If you are overweight or have obesity, losing weight can help control blood pressure and decrease the risk of complications. Ask your healthcare professional what is the ideal weight for you.
  • Do not smoke or use tobacco. Smoking is a major risk factor for heart disease. If you smoke and can't stop smoking, talk with your health care team about the programs or treatments that can help.
  • Limit the consumption of alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
  • Ask about the exercises. How long and hard you are able to exercise may depend on the severity of the stenosis of the mitral valve and the intensity of the exercise. Talk with your health care team about the amount and type of exercise is best for you, especially if you are thinking about competitive sports. People with mitral stenosis severe should not do competitive sports.
  • Get health checkups. Regular medical checkups are important if you have stenosis of the mitral valve. You should have an echocardiogram at least every year. If you often feel your heart beating with force, or hit it fast, get medical help. Fast heart rhythms that are not treated can quickly get worse in people with mitral valve stenosis.
  • Manage stress. Find ways to help manage stress, such as through relaxation, meditation, physical activity, and spend time with family and friends.
  • Sleep well. Lack of sleep can increase the risk of heart disease and other chronic conditions. Adults should aim to get 7 to 9 hours of sleep daily. Go to bed and wake up at the same time every day, including weekends. If you have trouble sleeping, talk with your health care professional about strategies that might help.

Pregnancy

If you have stenosis of the mitral valve and you want to become pregnant, talk with a health care professional in the first place. Pregnancy causes the heart to work harder. How a heart with stenosis of the mitral valve controls the extra work that depends on how narrow the valve is and how well the heart pumps. If you are pregnant and have mitral valve stenosis, your care team should closely monitor you during pregnancy. A health professional can explain that the medicines are safe to take during pregnancy. You and your healthcare professional can also discuss if you have heart valve treatment before pregnancy.

Preparing for your appointment

If you have mitral valve stenosis, you may see a physician skilled in diseases of the heart, called a cardiologist.

Here's some information to help you prepare for your appointment.

What you can do

  • Write down your symptoms and when they started.
  • List important medical information, including other health conditions you have and any family history of heart disease.
  • List of all the medications you are taking, including those bought without a prescription. To include in the dose.
  • Take someone with you to the appointment, if possible. Someone that goes hand in hand may help you remember the information.
  • Write down questions to ask your care provider.

Questions to ask your health care provider at the first appointment are:

  • What is the likely cause of my symptoms?
  • There are other possible causes of these symptoms?
  • What tests do I need?
  • You should see a specialist?

Questions if you are referred to a cardiologist include:

  • What is my diagnosis?
  • What treatment do you recommend it?
  • What are the possible side effects of the medications that you recommend?
  • What will my recovery be like the treatment you recommend?
  • How are you going to check my health over time?
  • What is my risk of long-term complications of mitral valve stenosis?
  • Do I need to change my exercise routine?
  • What diet and lifestyle changes should I make?
  • I have other health conditions. How can I best manage them together?

It is important for you to understand your condition. Do not hesitate to ask other questions.

What to expect from your doctor

Your health care team usually asks a lot of questions, such as:

  • What are your symptoms?
  • When did your symptoms begin?
  • Do you always have symptoms, or come and go?
  • Do you have a rapid, fluttering or pounding of the heart?
  • Have you coughed up blood?
  • Exercise or physical activity to worsen your symptoms?
  • Do you have any family members with heart valve disease?
  • Has had rheumatic fever?
  • Are being treated or have recently been treated for any other health conditions?
  • Do you or do you smoke? How much? When did you quit smoking?
  • Make use of alcohol or caffeine? How much?
  • You are planning to become pregnant in the future?

What you can do in the meantime

While you wait for your appointment, find out if any of the members of your family have a heart condition. The symptoms of mitral valve stenosis are similar to those of other heart conditions. Some of these conditions can occur in families. Knowing about your family's medical history helps your health care team to decide about their diagnosis and treatment.

If exercise makes your symptoms worse, do not exercise until you see your health care professional.

Symptoms and treatment of Mitral valve stenosis