Mitral Valve Stenosis

Symptoms of Mitral Valve Stenosis

Mitral valve stenosis causes a buildup of pressure in the heart that is directed back to the lungs, resulting in fluid buildup (congestion), shortness of breath and other symptoms. The condition typically progresses slowly over time. Some people with mitral valve stenosis may not notice any symptoms while others may experience mild symptoms for decades. Symptoms usually appear between the ages of 15 and 40 but can develop at any age, including during childhood.

Mitral valve stenosis symptoms include:

• Shortness of breath, especially during activity or when lying down
• Fatigue, especially during increased activity
• Swollen legs or feet
• Palpitations
• Chest pain or discomfort
• Coughing up blood
• Dizziness or fainting
• Heart murmur
• Lung congestion
• Arrhythmias (irregular heart rhythms)

Anytime your heart rate increases, such as during exercise, could cause mitral valve stenosis symptoms to appear or worsen. Pregnancy, infection or other things that cause stress on the body can also trigger symptoms.

Diagnosis of Mitral Valve Stenosis

To diagnose mitral valve stenosis, your doctor will perform a physical examination, ask you questions about your symptoms, and ask you about you and your family’s medical history. As part of the physical examination, your doctor will listen to your heart with a stethoscope. An abnormal heart sound, called a heart murmur, typically accompanies mitral valve stenosis. In addition, your doctor will also listen to your lungs to check for lung congestion (fluid buildup) that can occur in connection with mitral valve stenosis.

Based on the physical examination, your doctor will decide which tests are needed to confirm a diagnosis and whether you should be referred to a cardiologist. Tests used in the diagnosis and assessment of mitral calve stenosis include:

• Electrocardiogram (ECG): to assess heart rhythm.
• Chest X-ray: X-ray images can identify enlargement of the heart and show the condition of the lungs.
• Transthoracic echocardiogram: To confirm diagnosis of mitral valve stenosis, a wand-like device (transducer) is used to direct sound waves directed at your heart through your chest to produce video images of your heart in motion.
• Transesophageal echocardiogram: To provide your doctor with a more detailed look at the mitral valve than is possible with a standard echocardiogram, a wand-like device attached to the end of a tube is inserted down your esophagus to provide video imaging.
• Cardiac catheterization: Though not often used in the diagnosis of mitral valve stenosis, this test may be used if other tests cannot diagnose the condition or assess its severity. Cardiac catheterization involves navigating a thin tube (catheter) through a blood vessel, usually in your groin, to an artery in your heart. Dye is injected into the catheter to make the artery easier to see in an X-ray.

Treatment of Mitral Valve Stenosis

Although mitral valve stenosis cannot be cured by medication, certain drugs can help manage symptoms. These medications include drugs that treat high blood pressure, symptoms of heart failure (for example, swelling from fluid buildup) and fast heart rhythms; blood thinners to prevent stroke; and antibiotics to prevent heart valve damage.

You may need to have your mitral valve repaired or replaced. Specific procedures used to treat mitral valve stenosis include:

• Catheter-based procedures: These procedures allow a doctor to access your heart by inserting a thin tube (catheter) into an artery somewhere else in your body. The catheter is guided to your heart to repair or replace the valve. Specific catheter-based procedures include:
  • Balloon valvotomy: Also called valvuloplasty, this procedure involves a catheter with a balloon attached at one end. Once it is threaded into the mitral valve, the balloon is inflated to widen the narrowed area.
  • Valve replacement: In some cases, your doctor may recommend replacing your mitral valve via a catheter-based procedure. This procedure is called transcatheter mitral valve replacement, or TMVR.
• Surgery: For the surgical repair or replacement of the mitral valve, a number of methods are available, including minimally invasive surgery or robotically assisted surgery.