Mitral Stenosis -- Adult

Mitral stenosis is a narrowing of the mitral valve in the heart. This valve is located between the upper chamber and the lower pumping chamber of the left side of the heart. Blood must flow from the atrium, through the mitral valve, and into the ventricle before being pumped out into the rest of the body. Mitral stenosis may result in poor blood flow between the two left chambers, so not enough blood and oxygen is pumped throughout the body.

  • Causes


    The most common cause of mitral stenosis is
    rheumatic fever, which scars the mitral valve. A less common cause is a congenital defect, usually part of a complex of multiple heart defects present at birth. Very rare causes include infectious endocarditis, blood clots, tumors, or other growths that block blood flow through the mitral valve.

  • Definition

    Mitral stenosis is a narrowing of the mitral valve in the heart. This valve is located between the upper chamber and the lower pumping chamber of the left side of the heart. Blood must flow from the atrium, through the mitral valve, and into the ventricle before being pumped out into the rest of the body. Mitral stenosis may result in poor blood flow between the two left chambers, so not enough blood and oxygen is pumped throughout the body.

    Mitral Valve Stenosis
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  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor may be alerted to mitral stenosis by the following:


    • Abnormal heartsounds, such as a
      heart murmur
      or snap
    • Stretching of a vein in the neck
    • Signs of fluid in the lungs

    Images may be taken of your chest. This can be done with:

    • Chest x-ray
    • Echocardiogram
    • Transesophageal echocardiogram
    • Cardiac catheterization

    Your heart activity may need to be monitored. This can be done with:

    • Electrocardiogram
      (ECG, EKG)
    • Holter monitor

  • Prevention

    Most cases of mitral stenosis can be avoided by preventing rheumatic fever:


    • Treat
      strep throat
      infections promptly to avoid rheumatic fever, which can cause scarring of the heart valve. Always finish all of the antibiotics prescribed, even if you feel better before taking all of the doses.

    Avoid IV drug use

    In addition, there are several things you can do to try to avoid some of the complications of mitral stenosis:

    • Get regular medical care, including checkups and periodic electrocardiograms.
    • Talk to your dentist and doctor about your condition before any medical or dental procedures. It is no longer recommended that you take antibiotics to prevent infections before dental or medical procedures, but it may be necessary in some cases.
    • If your valve problem was caused by rheumatic fever, talk to your doctor about antibiotic treatment to prevent future episodes of rheumatic fever.
    • Avoid caffeine, alcohol, and drugs that speed up your heart rate. They will only worsen your symptoms.
    • Maintain a healthy weight.
    • Follow your doctor’s recommendations for exercise.
    • Ask your doctor about cutting back on salt. This may help decrease the pressure in your heart and improve your symptoms.

    • Monitor your blood pressure and inform your healthcare provider if you seem to be developing
      high blood pressure, which can worsen your symptoms.

  • Risk Factors

    Mitral stenosis pesents most often between ages 30-50 years old. The main risk factor for is rheumatic fever. Other factors that increase your risk of mitral valve stenosis include:

    • Congenital abnormality of the valve
    • Sex: female
    • Family history
    • History of radiation treatment to the chest
    • IV drug use

  • Symptoms

    Symptoms may include:

    • Difficulty breathing, especially during exercise and when lying flat
    • Awakening short of breath in the middle of the night
    • Fatigue
    • Sensation of rapid or irregular heartbeat
    • Cough with exertion
    • Coughing up blood
    • Swelling of the legs or feet
    • Frequent respiratory infections
    • Lightheadedness, fainting
    • Chest pain, such as squeezing, pressure, or tightness—rare

  • Treatment

    If you have mild mitral stenosis, your condition will need to be monitored, but may not need immediate treatment for symptoms associated with mitral stenosis. When symptoms become more severe, you may need to limit exertion and avoid high-salt foods. In addition, treatments may include:


    If you are diagnosed with mitral stenosis, follow your doctor's
    instructions.