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Mitral Stenosis

Mitral stenosis is a heart valve disorder that involves the mitral valve. This valve separates the upper and lower chambers on the left side of the heart. Stenosis refers to a condition in which the valve does not open fully, restricting blood flow.

As the valve area becomes smaller, less blood flows to the body. The upper heart chamber can swell as pressure builds up. Blood may flow back into the lungs. Fluid can collect in the lung tissue, making it hard to breathe. This condition is called pulmonary edema.

In adults, mitral stenosis occurs most often in those who have had rheumatic fever, a condition that may develop after strep throat or scarlet fever. The valve problems develop five to 10 years after the infection. Rheumatic fever is becoming rare in the United States, so mitral stenosis is also less common. Only rarely do other factors cause mitral stenosis in adults. These include calcium deposits forming around the mitral valve, radiation treatment to the chest, and some medications.

Children may be born with mitral stenosis.

Symptoms:

Adults may have no symptoms. Symptoms may appear or get worse with exercise and may include:

  • Chest discomfort
    • Increases with activity, decreases with rest
    • Radiates to the arm, neck, jaw or other areas
    • Includes tight, crushing pressure, squeezing or constricting
  • Cough, possibly bloody
  • Difficulty breathing during or after exercise or when lying flat
  • Fatigue, tiring easily
  • Frequent respiratory infections such as bronchitis
  • Sensation of feeling the heartbeat (palpitations)
  • Swelling of feet or ankles

In infants and children, symptoms may be present from birth and almost always develop within the first two years of life. Symptoms may include bluish discoloration of the skin or mucous membranes (cyanosis), poor growth or shortness of breath.

Treatment:

Treatment depends on the symptoms and condition of the heart and lungs. People with mild symptoms or none at all may not need treatment. Hospitalization may be required for diagnosis and for treatment of severe symptoms. There are a number of treatment options.

Medications are used to treat symptoms of heart failure or abnormal heart rhythms. These include diuretics, nitrates and beta-blockers. High blood pressure should also be treated.

Anticoagulants (blood thinners) are used to prevent blood clots from forming and traveling to other parts of the body.

Some patients may need heart surgery to repair or replace a valve. Replacement valves can be made from different materials, some of which may last for decades and others of which can wear out and require replacement.

Percutaneous mitral balloon valvotomy (also called valvuloplasty) may be considered instead of surgery.

Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.