Mitral Stenosis -- Child

Mitral stenosis is a narrowing of the mitral valve in the heart. The mitral valve is in the left side of the heart between the upper and lower chambers of the heart. When working properly, the valve helps to keep blood flowing in the right direction from the upper to the lower chambers. Mitral stenosis makes it difficult for blood to move from the upper and lower chambers. This means there is less blood for the lower chamber to pump out to the body. The blood can also back up in the upper chamber and push back into the lungs.

  • Causes


    The most common cause of mitral stenosis is
    rheumatic fever
    . This infection that may develop after strep throat or scarlet fever and can scar the heart valves. Mitral stenosis may develop 5-10 years after this infection occurs.

    Less common or very rare causes include:

    • Birth defect
    • Blood clots
    • Tumors
    • Infective endocarditis
    • Other growths that block blood flow through the mitral valve

  • Definition

    Mitral stenosis is a narrowing of the mitral valve in the heart. The mitral valve is in the left side of the heart between the upper and lower chambers of the heart. When working properly, the valve helps to keep blood flowing in the right direction from the upper to the lower chambers.

    Mitral stenosis makes it difficult for blood to move from the upper and lower chambers. This means there is less blood for the lower chamber to pump out to the body. The blood can also back up in the upper chamber and push back into the lungs.

    Mitral Valve Stenosis
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  • Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. The doctor may suspect mitral stenosis from:


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

    The diagnosis will be made after observing the mitral valve itself. Images of the heart and its structures may be taken during:

    • Echocardiogram
      —can also show the motion of the heart
    • Chest x-ray
    • Transesophageal echocardiogram
      —a tube that runs from the mouth into the stomach to better examine the mitral valve
    • Cardiac catheterization

    The heart's abilities may also be tested with:

    • Electrocardiogram
      (ECG, EKG)—a record of the electrical activity of the heart
    • Stress test
      —test how the body responds to physical exertion

  • Prevention

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


    • Treat
      strep throat
      infections right away to avoid rheumatic fever, which can cause scarring of the heart valve.
    • Always make sure your child finishes all of the antibiotics given, even if he feels better.

  • Risk Factors

    The main risk factor for mitral stenosis is rheumatic fever. Other risk factors may include:

    • Being born with mitral valve problems
    • Having other health problems that affect blood flow in the heart

  • Symptoms

    Symptoms are caused by the problems with blood flow and may include:

    • Hard time breathing, especially during exercise and when lying flat
    • Waking up short of breath in the middle of the night
    • Tiredness
    • Sensation of rapid or irregular heartbeat
    • Cough with exertion
    • Coughing up blood
    • Swelling of the legs or feet
    • Frequent respiratory infections
    • Dizziness, fainting
    • Chest pain, like squeezing, pressure, or tightness (rare)

  • Treatment

    If your child has mild mitral stenosis, immediate treatment may not be needed. Your doctor will monitor your child's condition to look for potential problems. Other treatment options include:

    Follow the doctor's instructions if your child is diagnosed with mitral stenosis.