Mitral Valve Stenosis

Mitral valve stenosis is the narrowing of the opening of the heart's mitral valve. Here, thickened valve halves (cusps or leaflets) do not open and close properly and causes interference with blood flow.

Thickened leaflets in mitral valve stenosis.
Thickened mitral halve leaflets of the left atrium.

Symptoms of Mitral Valve Stenosis

The symptoms of mitral heart stenosis are:

  • Shortness of breath (dyspnea), especially when lying down
  • Difficulty breathing, to the point of waking up with inability to breathe
  • Fatigue or weakness
  • Rapid heart beat or palpitations
  • Blood in cough or spit (hemoptysis)

In many cases, the symptoms of this disease is very mild and may not be noticeable.

Possible Complications

Many people with this condition never develop any noticeable symptoms or health problems.

However, the narrowing of the valve opening causes increased pressure in the atrial chamber, which causes fluid to backup into the lungs and results in pulmonary congestion and edema.

If the thickening of the mitral valve halves also prevents the valve from fully closing, blood can flow "backward" into the left atrium of the heart (called mitral valve regurgitation), which cause the left ventricle to pump harder and harder. This can ultimately lead to enlarged and weakened ventricle.

Because of this improper "backward" flow of blood, blood flow int he atrial chamber can become stagnant or turbulent. This can cause small clots to form. If these clots are dislodged, they can cause the following complications:

  • Pulmonary edema, if these clots lodge in the lungs' arteries
  • Stroke, if they travel to the brain
  • Pain in the hands and feet, due to emboli or arterial obstruction if the clots travel there.

If left untreated, long-term mitral valve stenosis can also cause high lung pressure or pulmonary hypertension.

Mitral Valve Stenosis Treatment

People who have been diagnosed with heart valve abnormalities should inform their doctors, surgeons, and dentists before any medical or dental procedures. Usually, a precautionary dose of antibiotics is necessary to reduce the risk of developing heart infections, such endocarditis.

Patients with heart palpitations or atrial fibrillation may be treated with:

  • Digoxin or other antiarrhytmic medications to help regulate the heart's rhytm
  • Blood-thinning medications, such as warfarin or coumadin

In cases of severe valve defect, the following surgical procedures may be performed:

  • Balloon valvuloplasty
    In this procedure, a flexible catheter is inserted into the constricted area and a balloon on its tip is inflated, which forces the valve to open.

  • Commissurotomy
    Here, the valve halves are surgically widened

  • Valve transplant
    For severely damaged valves, transplantation with an artificial or mechanical valve or valve from pig's heart may be necessary.

Prognosis

When treated early, the prognosis for mitral valve stenosis is good. Similarly, the prognosis for valve surgeries and even transplant are good.






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