What is mitral stenosis? Symptoms and treatment

What is mitral stenosis? Symptoms and treatment

The mitral valve is one of the four valves in the human heart. Each heart valve serves both to allow blood to flow freely between the chambers and to prevent blood from flowing backward. If the valve narrows, that is, stenosis occurs, blood flow is blocked and the body cannot get the oxygenated blood it needs.

Symptoms of mitral stenosis

Symptoms of mitral stenosis include:

  • Fatigue
  • Shortness of breath while moving
  • Difficulty breathing when lying down
  • Heart palpitations
  • Excessive swelling of the ankles or feet
  • Frequent upper respiratory tract infection
  • Persistent cough
  • Pain or discomfort in the chest area

Usually the patient has only mild symptoms for many years. Physical stress, such as pregnancy or respiratory infection, may contribute to the symptoms of mitral stenosis.

Even with severe mitral stenosis, a patient may be completely asymptomatic. Therefore, cardiac surgeons often refer to this disease as the "silent killer." Even if the patient has no symptoms, his heart can dilate to the point where it leads to heart failure and death.

Diagnosis of mitral stenosis

Sometimes mitral stenosis is detected when a patient goes to the doctor for another condition. During auscultation of the heart, the doctor may hear abnormal heart murmurs through a stethoscope. This will direct the doctor to perform additional examinations.

Symptoms usually develop between the ages of 40 and 50. However, the condition can also occur in infants and children. Younger patients may have no symptoms, or they may experience fatigue and shortness of breath during strenuous physical activity.

Some symptoms of mitral stenosis are not felt by the patient. Heart murmurs, pulmonary hypertension (increased pressure in the pulmonary artery), pulmonary congestion, arrhythmias (irregular heartbeat), or intracardiac blood clots can only be detected by a doctor.

Echocardiography (EchoCG) is the primary test for diagnosing heart valve disease, including mitral stenosis.

Causes of mitral stenosis

The main cause of mitral stenosis is rheumatic fever (rheumatism). Rheumatic fever usually develops after a streptococcal throat infection. Rheumatic fever is accompanied by lesions of the mitral valve, and sometimes other parts of the heart. In rare cases, mitral stenosis may be congenital.

Mitral stenosis may also be caused by tumors or blood clots that block the lumen of the valve. In older patients, calcium deposits may form around the valve or on the mitral valve itself, causing stenosis. Radiation therapy and certain medications can also cause stenosis.

Risks associated with mitral stenosis

These risks include:

  • Heart failure
  • Pulmonary edema is a build-up of fluid in the lungs
  • Fluid buildup in the abdomen and ankles
  • Enlargement of the heart's left atrium (because it is trying to push blood through a narrow valve with high pressure)
  • Atrial fibrillation is a type of arrhythmia that can cause clots to form inside the heart. If these clots break off and move to other parts of the body, especially the brain, they can cause serious problems.

Treatment for mitral stenosis

Currently, there are no medications that can cure mitral stenosis. However, your doctor may prescribe medicines that relieve symptoms, reduce the strain on your heart, and regulate your heart rhythm and rate.

Diuretics may be prescribed to reduce fluid retention. Anticoagulants may be used to reduce blood clotting. As a preventive measure, antibiotics may be taken before going to the dentist to reduce the risk of infection by bacteria that may enter the patient's bloodstream and settle in the heart (cause valve disease).

There are many methods to repair the structure of a stenosed valve. The decision to repair or replace the mitral valve depends on the overall health of the patient and the severity of the valve leaflet damage.

Balloon valvuloplasty is a non-surgical procedure in which a balloon is inserted into the heart through a catheter. After placement, the balloon is inflated to open the mouth of the mitral valve. This procedure is not performed on patients with coronary heart disease. This is because during the procedure, the mass (a section of the valve) may dislodge, enter the bloodstream, and migrate to other organs.

Although the mitral valve can sometimes be repaired, the disease often requires valve replacement (prosthetics). If a mechanical valve is used as a prosthetic valve, the patient will need a lifetime of blood clot-reducing medications (anticoagulants) to prevent blood clots from forming on the valve. The advantage of these artificial valves is their strength and durability. Some patients are implanted with a biological (tissue) valve. These are mainly derived from pigs and cattle. Patients with biological valves do not need to take anticoagulants. The disadvantage of these artificial valves is that they can be damaged after a certain period of time and repeated valve interventions may be necessary.