Mitral Valve Stenosis

Mitral valve stenosis is a disease characterized by narrowing of the opening of the mitral valve . since the mitral valve is the gate of blood flow from the left atrium to the left ventricle, this narrowing will increase the resistance to the blood flowing through the valve.

As a result of this resistance, blood will accumulate in the left atrium increasing its pressure and left atrial enlargement will occur. With time, the left atrium becomes larger and irregularity in the heart rhythm will occur (atrial fibrillation). The left atrium ability to pump blood will be lost and blood accumulates more in the left atrium resulting in increase pressure in the pulmonary veins draining the blood from the lungs. Fluid will accumulate in the lungs resulting lung congestion and a decrease in the level of oxygen in blood.

Causes of mitral valve stenosis

Rheumatic fever is the number one cause of Mitral valve stenosis. This is a disease of childhood that follows improperly treated streptococcal throat infection or scarlet fever. Rheumatic fever is common in developing countries and can rarely be seen in USA and Europe due to wide spread use of proper antibiotics to treat streptococcal infections. the disease is prevalent in children and teenager of developing countries and it can be seen in old population in USA. Rheumatic fever can affect any valve of the heart , but the mitral valve is the most commonly affected.

in few cases some infants can be born with congenital mitral stenosis and they will mostly need surgery early in their life.

sometime mitral valve stenosis can be caused by benign tumor of the left atrium called myxoma. This tumor can grow big in size and sometimes protrude in the mitral valve orifice leading to its narrowing.

Symptoms and Diagnosis

In early cases of mild mitral valve stenosis, the patient may not encounter any symptoms. as the disease progresses and become more severe, patients will develop irregular heart beats and heart failure. Easy fatigue and shortness of breath are common symptoms during this stage. With time shortness of breath can be experienced even at rest or when lying flat on bed. Coughing of blood (hemoptysis) is not uncommon and patients should seek immediate medical help if they develop it. Some patients may develop a characteristic mitral facies in which their cheeks look red-flushed.

During physical examination, you doctor will hear a characteristic heart murmur as the blood tries to flow through the narrowed mitral valve. An echocardiogram is usually ordered to confirm the diagnosis and to give a detailed image of the heart and all the valves.

Treatment of Mitral valve stenosis

As I always say, best treatment is prevention. The most important is the prevention of rheumatic fever by properly treating streptococcal infections with antibiotic for at least one week.

Early cases of mitral stenosis will require diuretics or water pills to decrease congestion of the lungs and the symptoms of heart failure. Heart rhythm controlling drugs, such as digoxin, or calcium channel blockers, will be prescribed to treat atrial fibrillation. Anticoagulants or blood thinners will also be used to prevent development of blood clots inside irregularly beating atrium.

As the disease progresses, valve repair or replacement will be the only solution. If the valve is not so hardly calcified, it can be dilated using a balloon tipped catheter, in a procedure called balloon valvuloplasty. The procedure is done in the Cath. Lab. under local Anesthesia . When the mitral valve is severely damaged, it is usually replaced with a mechanical or tissue valve. Anticoagulants will be prescribed after valve replacement.

Patients with mitral valve stenosis or those whose valves are replaced will require antibiotics before some dental and surgical procedures.

Watch These Videos About Mitral valve Stenosis:

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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