Mitral Valve Stenosis: Symptoms, Causes, Treatment

What are the symptoms of mitral valve stenosis?

Mitral valve stenosis is a condition where the mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle. The symptoms of mitral valve stenosis can vary in severity and may not always be present. Here are some common symptoms:

Shortness of breath: Shortness of breath, even at rest, is a common symptom of mitral valve stenosis.
Fatigue: Fatigue or weakness, especially with exercise, is another common symptom.
Chest pain: Chest pain or discomfort, which may be worse with exertion, can occur due to decreased blood flow to the heart muscle.
Dizziness or lightheadedness: Dizziness or lightheadedness can occur due to decreased blood flow to the brain.
Swollen legs and feet: Fluid buildup in the legs and feet (edema) can occur due to increased pressure in the veins.
Coughing up pink froth: Coughing up pink froth or sputum can occur due to increased pressure in the lungs.
Palpitations: Palpitations or irregular heartbeat can occur due to decreased blood flow to the heart muscle.
Decreased exercise tolerance: Patients with mitral valve stenosis may experience decreased exercise tolerance due to fatigue or shortness of breath.
Congestive heart failure: In severe cases, mitral valve stenosis can lead to congestive heart failure, which is characterized by fluid buildup in the lungs and other parts of the body.

The symptoms of mitral valve stenosis can be similar to those of other conditions, such as mitral valve regurgitation or coronary artery disease. A thorough physical examination and diagnostic tests are necessary to confirm the diagnosis.

It’s essential to consult with a healthcare provider if you experience any symptoms that could be related to mitral valve stenosis. Early diagnosis and treatment can help alleviate symptoms and prevent complications.

What are the causes of mitral valve stenosis?

Mitral valve stenosis is a condition where the mitral valve becomes narrowed, restricting blood flow from the left atrium to the left ventricle. The causes of mitral valve stenosis can be classified into two main categories: acquired and congenital.

Acquired causes:

Rheumatic fever: Rheumatic fever is a bacterial infection that can cause inflammation and scarring of the mitral valve, leading to stenosis.
Cardiomyopathy: Cardiomyopathy is a condition where the heart muscle becomes weakened, leading to decreased pumping efficiency and increased pressure on the mitral valve.
Coronary artery disease: Coronary artery disease can cause blockages in the coronary arteries, leading to decreased blood flow to the heart muscle and increased pressure on the mitral valve.
Cardiac surgery: Cardiac surgery, such as heart transplantation or valve replacement, can cause scarring and inflammation of the mitral valve, leading to stenosis.
Mitral annular calcification: Calcification of the mitral annulus can cause stiffening of the valve ring, leading to stenosis.

Congenital causes:

Mitral valve atresia: Mitral valve atresia is a rare congenital condition where the mitral valve is absent or severely narrowed.
Mitral stenosis with cleft mitral leaflet: Mitral stenosis with cleft mitral leaflet is a congenital condition where the mitral valve leaflets are abnormal and do not close properly.
Down syndrome: Down syndrome is a genetic disorder that can increase the risk of developing mitral valve stenosis.

How is the diagnosis of mitral valve stenosis made?

The diagnosis of mitral valve stenosis is typically made through a combination of medical history, physical examination, and diagnostic tests. Here are the steps involved in making a diagnosis:

Medical history: The healthcare provider will ask questions about the patient’s medical history, including symptoms, previous heart problems, and family history of heart conditions.
Physical examination: A physical examination will be performed to check for signs of mitral valve stenosis, such as:
- Murmurs (abnormal heart sounds)
- Increased blood pressure
- Reduced blood pressure in the arms and legs
- Enlarged liver and spleen
- Swelling in the legs and feet
Electrocardiogram (ECG): An ECG is a non-invasive test that records the electrical activity of the heart.
Echocardiogram (Echo): An echocardiogram is a non-invasive test that uses sound waves to create images of the heart.
Transesophageal echocardiogram (TEE): A TEE is a more detailed version of an echocardiogram that uses a probe inserted through the mouth to image the heart.
Cardiac catheterization: Cardiac catheterization is a minimally invasive procedure that involves inserting a catheter into an artery in the leg and guiding it to the heart to evaluate blood flow and pressure.
Cardiac MRI: A cardiac MRI is a non-invasive test that uses magnetic fields and radio waves to create detailed images of the heart.
Cardiac CT scan: A cardiac CT scan is a non-invasive test that uses X-rays and computer technology to create detailed images of the heart.

Diagnostic criteria:

Doppler flow patterns: Doppler flow patterns on echocardiography or cardiac catheterization can help diagnose mitral valve stenosis.
Mitral valve morphology: The anatomy of the mitral valve can be evaluated using echocardiography or TEE.
Blood pressure measurements: Blood pressure measurements can help diagnose mitral valve stenosis by assessing the pressure gradient across the mitral valve.

A diagnosis of mitral valve stenosis is typically made based on a combination of these diagnostic tests and clinical evaluation.

What is the treatment for mitral valve stenosis?

The treatment for mitral valve stenosis depends on the severity of the condition and the patient’s overall health. Here are some common treatments for mitral valve stenosis:

Medical treatment:

Blood thinners: Blood thinners may be prescribed to prevent blood clots from forming and to reduce the risk of stroke or heart attack.
Beta blockers: Beta blockers may be prescribed to slow down the heart rate and reduce symptoms such as palpitations and shortness of breath.
Diuretics: Diuretics may be prescribed to reduce fluid buildup in the body and alleviate symptoms such as swelling and shortness of breath.

Surgical treatment:

Mitral valve repair: Surgical repair of the mitral valve may be necessary to restore its normal function.
Mitral valve replacement: Surgical replacement of the mitral valve with a prosthetic valve may be necessary in severe cases.
Heart transplantation: In severe cases, heart transplantation may be necessary if the mitral valve stenosis is caused by a congenital heart defect or other condition that cannot be treated with surgery.

Minimally invasive procedures:

Balloon valvuloplasty: A minimally invasive procedure that uses a balloon to widen the mitral valve opening.
Catheter-based procedures: Minimally invasive procedures that use a catheter to repair or replace the mitral valve.

Percutaneous mitral valve repair (PMVR): A minimally invasive procedure that uses a catheter to repair the mitral valve without open-heart surgery.

Transcatheter mitral valve replacement (TMVR): A minimally invasive procedure that uses a catheter to replace the mitral valve with a prosthetic valve.

It’s essential to consult with a healthcare provider to determine the best course of treatment for your specific condition.

What is the mortality rate for mitral valve stenosis?

The mortality rate for mitral valve stenosis varies depending on the severity of the condition, the patient’s overall health, and the presence of other underlying medical conditions. Here are some general mortality rates for mitral valve stenosis:

Symptomatic mitral valve stenosis:

10-year mortality rate: 30-50%
20-year mortality rate: 60-80%

Asymptomatic mitral valve stenosis:

10-year mortality rate: 5-15%
20-year mortality rate: 20-40%

Surgical treatment of mitral valve stenosis:

In-hospital mortality rate: 1-5%
Late mortality rate (within 30 days after surgery): 5-10%

Percutaneous mitral valve repair (PMVR):

In-hospital mortality rate: <1%
Late mortality rate (within 30 days after procedure): <5%

Transcatheter mitral valve replacement (TMVR):

In-hospital mortality rate: <1%
Late mortality rate (within 30 days after procedure): <5%

It’s essential to note that these mortality rates are based on general population studies and may not reflect individual outcomes. The actual mortality rate for a specific patient with mitral valve stenosis will depend on various factors, including their age, overall health, and other underlying medical conditions.