Mitral stenosis


Mitral stenosis

Description, Causes and Risk Factors:

Mitral stenosis is a narrowing of the mitral valve opening that increases resistance to blood flow from the left atrium to the left ventricle. Mitral stenosis usually results from rheumatic fever, but infants can be born with the condition. Mitral stenosis does not usually cause symptoms unless it is severe.

In mitral stenosis, blood flow through the narrowed valve opening is reduced. As a result, the volume and pressure of blood in the left atrium increases, and the left atrium enlarges. The enlarged left atrium often beats rapidly in an irregular pattern (a disorder called atrial fibrillation). As a result, the heart's pumping efficiency is reduced. If mitral stenosis is severe, pressure increases in the blood vessels of the lungs, resulting in heart failure with fluid accumulation in the lungs and a low level of oxygen in the blood. If a woman with severe mitral stenosis becomes pregnant, heart failure may develop rapidly.

Scarring caused by rheumatic fever is the leading cause of mitral stenosis. Although rheumatic fever is common in some countries, it is becoming rare in the United States. Uncommon causes of mitral stenosis are calcification of the mitral valve leaflets, and as a form of congenital heart disease. However, there are primary causes of mitral stenosis that emanate from a cleft mitral valve. Other causes include infective endocarditis where the vegetations may favor increase risk of stenosis. It is the most common valvular heart disease in Pregnancy.

Both rheumatic fever and mitral stenosis remain common in developing countries. Mitral stenosis develops at an earlier age, progresses more quickly, and requires earlier intervention.

Symptoms:

    Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND).

  • Palpitations.

  • Chest pain.

  • Hemoptysis.

  • Thromboembolism.

  • Fatigue and weakness.

Diagnosis:

There are several tests that your doctor may use to diagnose mitral stenosis:

Physical Exam: Your doctor will listen to your heart with a stethoscope. In people with this condition, the heart often makes unusual sounds such as rumbling and snapping.

Imaging Tests: Your doctor may use a variety of imaging tests to determine the cause of symptoms, including:

    Echocardiogram: an image of the heart's structure and function produced by ultrasound waves.

  • X-rays of heart and lungs (looking at size of left atrium and whether lungs are congested).

  • Transesophageal echocardiography: an image of the heart produced when a device that emits ultrasound waves is threaded into your esophagus. This method creates a more detailed picture than a traditional echo because the esophagus is right behind the heart.

  • Cardiac catheterization: a long, thin tube is inserted into your arm, upper thigh, or neck and threaded up to your heart. This allows your doctor to do a variety of tests, including getting an image of the heart's blood vessels.

Tests that can monitor your heart for rhythm abnormalities include:

    Electrocardiogram: a recording of your heart's electrical activity

  • Holter monitoring: when your heart's electrical activity is recorded using a portable monitoring device worn over a period of time (24-48 hours usually).

  • Stress Tests: Your doctor may have you work out, and then monitor you while you exercise to determine how your heart responds to physical stress.

Treatment:

Treatment for mitral valve stenosis can vary greatly depending on your symptoms and the severity of the condition. If you have no symptoms and only mild mitral valve stenosis, you might not need any treatment.

Drugs & Medication: If your mitral valve stenosis is causing symptoms, your doctor might prescribe medications. Although these do not actually fix the problem with your mitral valve, they can help treat your symptoms. Types of medications your doctor might prescribe include:

  • Anticoagulants (blood thinners).

  • Diuretics (to reduce fluid buildup through increased urine output).

  • Antiarrhythmics (medications to treat abnormal heart rhythms).

  • Beta-blockers (medications to slow your heart rate).

Other treatment options:

    Valvuloplasty: Your doctor may choose to perform a mitral balloon valvuloplasty if you need more treatment than just medications but your mitral valve is not damaged enough to require surgery. This involves threading a tube (catheter) with a balloon attached to it through a vein and into your heart. Once in the mitral valve, the doctor inflates the balloon to expand the valve. In some cases, you may need to undergo this procedure more than once.

  • Surgery: Surgery may become necessary. Your doctor might be able to surgically repair your existing mitral valve to make it function properly. If that isn't possible, you may need to have your mitral valve replaced with a new one. The replacement might be biological (from a cow, pig, or human cadaver, for example) or mechanical.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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