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Mitral stenosis

Mitral stenosis is a disorder in which the mitral valve does not fully open. This
restricts the flow of blood.

Blood that flows between different chambers of your heart must flow through a
valve. The valve between the two chambers on the left side of your heart is called
the mitral valve. It opens up enough so that blood can flow from the upper chamber
of your heart (left atria) to the lower chamber (left ventricle). It then closes, keeping
blood from flowing backwards.
Mitral stenosis means that the valve cannot open enough. As a result, less blood
flows to the body. The upper heart chamber swells as pressure builds up. Blood and
fluid may then collect in the lung tissue (pulmonary edema), making it hard to
In adults, mitral stenosis occurs most often in people who have had rheumatic fever.
This is a disease that can develop after an illness with strep throat that was not
properly treated.

These include:  Calcium deposits forming around the mitral valve  Radiation treatment to the chest  Some medications Children may be born with mitral stenosis (congenital) or other birth defects involving the heart that cause mitral stenosis.10 years or more after having rheumatic fever. Rheumatic fever is becoming rare in the United States because strep infections are most often treated. Symptoms may not show up for even longer. However. Symptoms Adults may have not symptoms. there are other heart defects present along with the mitral stenosis. Symptoms may include:  Chest discomfort that increases with activity and extends to the arm. Often. possibly with bloody phlegm  Difficulty breathing during or after exercise. Mitral stenosis may run in families. neck. such as bronchitis  Feeling of pounding heart beat (palpitations)  Swelling of feet or ankles . jaw or other areas (This is rare)  Cough. other factors can cause mitral stenosis in adults. Rarely. symptoms may appear or get worse with exercise or other activity that raises the heart rate. or when lying flat. This has made mitral stenosis less common. Symptoms may begin with an episode of atrial fibrillation (especially if it causes a fast heart rate). Symptoms may also be triggered by pregnancy or other stress on the body. or other heart disorders.  Waking up due to breathing problems (This is the most common symptom)  Fatigue  Frequent respiratory infections.The valve problems develop 5 . such as infection in the heart or lungs. Symptoms will most often develop between ages 20 and 50.

It will almost always develop within the first 2 years of life. For severe symptoms. Symptoms include:  Cough  Poor feeding. beta-blockers . high blood pressure and abnormal heart rhythms include:  Diuretics (water pills)  Nitrates. you may need to go to the hospital for diagnosis and treatment. or other abnormal heart sound may be heard. The sound often gets louder just before the heart begins to contract. symptoms may be present from birth (congenital). People with mild symptoms or none at all may not need treatment. Blood pressure is most often normal. snap. Narrowing or blockage of the valve or swelling of the upper heart chambers may be seen on:  Chest x-ray  CT scan of the heart   Echocardiogram ECG (electrocardiogram)  MRI of the heart  Transesophageal echocardiogram (TEE) Treatment Treatment depends on the symptoms and condition of the heart and lungs. Medicines which can be used to treat symptoms of heart failure.In infants and children. The exam may also reveal an irregular heartbeat or lung congestion. A murmur. or sweating when feeding  Poor growth  Shortness of breath Exams and Tests The health care provider will listen to the heart and lungs with a stethoscope. The typical murmur is a rumbling sound that is heard over the heart during the resting phase of the heartbeat.

Replacement valves can be made from different materials. Some may last for decades. Antibiotics may be used in some cases of mitral stenosis. a tube (catheter) is inserted into a vein. The antibiotics were given to prevent an infection of the damaged heart valve. Outlook (Prognosis) The outcome varies. the procedure may need to be repeated months or years later. Surgery to repair or replace the mitral valve. without symptoms. Complications may be severe or lifethreatening. These include:  Percutaneous mitral balloon valvotomy (also called valvuloplasty). This procedure may be tried instead of surgery in people with a less damaged mitral valve. People who have had rheumatic fever may need long-term preventive treatment with the antibiotic penicillin. mitral stenosis can be controlled with treatment and improved with valvuloplasty or surgery. most patients with heart valve problems were given antibiotics before dental work or invasive procedures. The disorder may be mild. Calcium channel blockers  ACE inhibitors  Angiotensin receptor blockers (ARBs)  Digoxin Anticoagulants (blood thinners) are used to prevent blood clots from forming and traveling to other parts of the body. A balloon on the tip of the catheter is inflated. antibiotics are now used much less often. widening the mitral valve and improving blood flow. In the past. In most cases. Even when successful. During this  procedure. Possible Complications . However. It is threaded up into the heart. usually in the leg. Some people may need heart surgery or procedures to treat mitral stenosis. Children often need surgery to either repair or replace the mitral valve. such as colonoscopy. Ask your doctor whether you need to use antibiotics. or may be more severe and become disabling over time. and others can wear out and need to be replaced.

or other areas  Congestive heart failure  Pulmonary edema  Pulmonary hypertension When to Contact a Medical Professional Call your health care provider if:  You have symptoms of mitral stenosis. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever. Discuss whether you need preventive antibiotics. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice GuidelinesJ Thorac Cardiovasc Surg. Endocarditis. or new symptoms appear. In: Goldman L. Tell your health care provider if you have a family history of congenital heart diseases.Goldman's Cecil Medicine Wilson w. Bownow RO et al. Taubert KA. Tell your health care provider about your heart valve disease before you receive any medical treatment. Alternative Names Mitral valve obstruction References Nishimura. et al. Atrial fibrillation and atrial flutter  Blood clots to the brain (stroke).  You have mitral stenosis and symptoms do not improve with treatment. Treat strep infections promptly to prevent rheumatic fever. and Kawasaki Disease Committee. . Prevention Follow your health care provider's recommendations for treating conditions that can cause valve disease. Otto CM. Gerwitz M. but complications can be prevented. RA. eds. Valvular heart disease. intestines. Mitral stenosis itself often cannot be prevented. Carabello BA. kidneys. Schafer AI.

Libby P.Circulation.Council on Cardiovascular Disease in the Young. and the Quality of Care and Outcomes Research Interdisciplinary Working Group. MD. University of Washington Medical School.A. Division of Cardiology. Council on Cardiovascular Surgery and Anesthesia. Isla Ogilvie.M. PhD. Mann DL. . Seattle. and the Council on Clinical Cardiology. MD.D. PhD. Update Date 5/13/2014 Updated by: Michael A. Bonow RO. eds. Editorial team. Otto CM. Also reviewed by David Zieve. Valvular heart disease. Associate Professor of Medicine. In: Bonow RO. Braunwald E. Harborview Medical Center. Chen. and the A.Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. WA. MHA. Zipes DP.