Mitral Valve Stenosis

Mitral valve stenosis means narrowing of the mitral valve. The mitral valve is the valve located on the left side of the heart between the left atrium and the left ventricle. This valve keeps flow of blood in one direction from the atrium to the ventricle.

Causes of mitral valve stenosis or narrowing:

1. Usually caused by rheumatic fever.
2. Another causes include: congenital mitral stenosis in which you are already born with a narrow valve, tumors as left atrial myxoma which blocks the opening of the valve as well as infections.

What will happen to your heart and body as a result of this narrowing?

In this condition, the two leaflets of the mitral valve gradually fuse together, making it difficult for the blood, that is traveling into the left atrium from the lungs, to pass through the mitral valve and into the left ventricle. As this condition becomes more severe, blood backs up into the lungs resulting accumulation of some fluid in the air sacs of the lungs (congestion).

Symptoms and signs:

1. Shortness of breath which can become severe to the extent that you cannot lie flat in your bed (orthopnea) or sometimes you can wake up 2 hours after sleeping with severe shortness of breath and air hunger (paroxysmal nocturnal dyspnea).
2. Fatigue is also a common symptom.
3. In some cases, the patient may cough up blood ( hemoptysis)
4. Irregular heart beat or palpitation are also common due to high incidence atrial fibrillation
5. On examination, your physician will listen to your heart and an abnormal sound called heart murmur is heard.

Diagnostic Tests

your doctor will order any or all of the following special diagnostic tests:

Chest x-ray: can provide doctors information about the size of your heart and its four chambers, as well as information about your lungs. Left atrial enlargement and congestion of your lungs are common findings.

Electrocardiogram (EKG) – This test records the changes of electrical activity occurring during your heartbeat. It helps to diagnose any irregularities in your heart's rate and rhythm, as well as in heart muscle enlargement or damage. Atrial fibrillation is a common finding in mitral stenosis

Echocardiogram (echo) – This test uses ultrasound to examine and measure the structure of your heart. It is very important in evaluating the area of your valve and the degree of narrowing. It gives idea about the quality of the valve and if it is heavily calcified or not. This data is very important in planning your treatment.

Cardiac catheterization (coronary arteriogram):  An angiogram will be ordered if your age is above 40. It is important to detect if your coronary arteries have significant blockages and in this caser your cardiac surgeon will perform coronary artery bypass surgery at the time of your valve surgery.

Treatment:

Medical: Prevention is the most important since rheumatic fever is the main cause. Adequate treatment for streptococcal throat infection is the key factor in the prevention of rheumatic fever and damage to your heart valves.

Ballon mitral valvotomy (BMV): This means widening of your mitral valve using cardiac catheterization. This is an option if your mitral valve is not heavily calcified and there is no associated mitral incompetence.

Surgery: If your valve is not calcified, it can be widened using an open heart surgery. If your valve is heavily calcified and it mostly damaged, it can be replace using a mechanical valve or a bioprosthetic (made from cows or pigs) valve.