Mitral Stenosis

Mitral stenosis confines the flow of blood through the valve. Back pressure which builds up behind the narrowed valve could cause various problems and symptoms. The more severe the narrowing, the more serious the issues. Medication may help to alleviate symptoms. Surgery to elongate, repair or replace the valve may be needed.

What’s the mitral valve?

The valve has two flaps (cusps). The valve allows blood to flow into the left ventricle when the left atrium contracts. (The aorta is the chief artery which takes blood to the body.)

The cusps are stopped from turning inside out by thin strands of tissue called chordae. The valve or chordae could get damaged or scarred which could keep the valve from working properly. This can lead to ailments called mitral stenosis, mitral regurgitation, or both.

What exactly is mitral stenosis?

It is narrowed (stenosed) when it is open. So, there’s some limitation of blood flow from the left atrium to the left ventricle. This in turn means there is a reduced quantity of blood that is pumped out into the body from the left ventricle. In general, the more narrowed the valve, the less blood that will get through, the more acute the problem is likely to be.

What are the Causes of Mitral Stenosis

The valve between both chambers in 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 reduced chamber (left ventricle). It subsequently shuts, keeping blood from flowing backwards.

Mitral stenosis ensures that the valve cannot open enough. As a result, less blood flows to the body. As pressure builds up the upper heart chamber swells. Blood and fluid may subsequently accumulate in the lung tissue (pulmonary edema), which makes it tough to breathe.

In grownups, mitral stenosis appears most often in those who have had rheumatic fever (a condition that could grow after untreated or poorly treated strep throat or scarlet fever). The valve troubles develop 5 – 10 years or more after the episode of rheumatic fever, and symptoms may not appear for even longer. Rheumatic fever is becoming rare in america as a result of treatment of strep diseases, so mitral stenosis is also less common.

 

Only rarely do other factors cause mitral stenosis in adults. These generally include:

  • Calcium deposits forming around the mitral valve
  • Radiation treatment to the torso
  • Some drugs

Often, there are other heart defects present with the mitral stenosis.
Mitral stenosis may run in families.

Do you know the Symptoms of Mitral Stenosis?

In grownups there could be no symptoms. Nevertheless, symptoms may appear or get worse with exercise or some action that raises one’s heart rate. In adults, symptoms typically develop between ages 20 and 50.

Symptoms may start with an episode of atrial fibrillation (particularly in case that it causes a quick heart rate). They can also be triggered by pregnancy or other stress in the body, like disease in the heart or lungs, or other heart ailments.

Symptoms might include:

  • Chest discomfort (uncommon)
  • Increases with activity, decreases with rest
  • Radiates to the arm, neck, jaw, or alternative regions
  • Tight, crushing, pressure, squeezing, constricting
  • Cough, potentially bloody (hemoptysis)
  • Trouble breathing during or after exercise or when lying flat; may wake up with difficulty respiration (most common symptom)
  • Exhaustion, becoming tired readily
  • Frequent respiratory infections such as bronchitis
  • Sensation of feeling the heart beat (palpitations)
  • Swelling of feet or ankles

In infants and children, symptoms could be there from birth (congenital), and typically grow within the first 2 years of life.

Symptoms contain:

  • Cough
  • Inferior feeding or perspiration when feeding
  • Poor increase
  • Shortness of breath

What complications may occur with mitral stenosis?

The key possible complications that could develop contain the following:

  • Atrial fibrillation grows in about 4 in 10 cases. That is where the heart beats in a rapid and irregular way. This occurs because the electrical signals in the enlarged atrium become defective. The unusual heart rhythm could cause palpitations, and make you even more breathless. See separate leaflet called Atrial Fibrillation.
  • Heart failure may grow and slowly become much more severe. This causes worsening shortness of breath, tiredness, and fluid retention in various tissues of the body. See separate leaflet called Heart Failure.
  • A blood clot may form inside the enlarged left atrium, which doesn’t completely empty to the ventricle with each pulse. A blood clot is more likely to occur if you too develop atrial fibrillation. A blood clot may travel through one’s heart, be carried in the bloodstream and get stuck and block a blood vessel in another part of the body. For example, it could get stuck in a blood vessel going to the brain and induce a stroke.
  • Endocarditis sometimes develops. This is an infection of the valve. (Damaged valves are more prone to disease than standard valves.) Unless promptly treated, endocarditis can cause serious sickness. See separate leaflet called Infective Endocarditis.

 

How is mitral stenosis diagnosed?

  • People with mitral stenosis gets flushed cheeks.
  • A doctor may hear a heart murmur or other strange noises when listening with a stethoscope.
  • The pressure in the jugular vein that runs across the side of the neck might be raised. A physician may have the capacity to find that the amount of blood in this vein is greater than regular.
  • The crown of the heart lies next to the chest wall and can normally be felt conquering against it (the apex beat). When one’s heart is larger than normal this can be found further to the left in mitral stenosis.
  • The liver might be swollen and you also may develop a distended stomach because of fluid.

Sounds and murmurs are the result of blood passing through strange valves, or to unusual motion of valves. There are typical noises and murmurs which happen with mitral stenosis. A scan of the heart, called an echocardiogram (heart echo), can confirm the analysis. Other heart tests, including CT scans and MRI scans may help to gauge the rigor of the problem.

 

What are the treatment for Mitral Stenosis?

Treatment relies upon the symptoms and condition of the heart and lungs. People with mild symptoms or none at all may not want treatment. For severe symptoms, you may need to go to the hospital for analysis and treatment.

Drugs are employed to treat symptoms of heart failure or unusual heart rhythms (most usually atrial fibrillation) and high blood pressure, together with to prevent blood clots.

These include diuretics (water pills), nitrates, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers (ARBs), or digoxin.
Anticoagulants (blood thinners) are used to stop blood clots from forming and traveling to other portions of the body.
Antibiotics might be used for some people with mitral stenosis:

Folks who have had rheumatic fever may want long-term preventative treatment with penicillin.

The antibiotics were provided to prevent an infection of the damaged heart valve. Nevertheless, antibiotics are actually used much less often before dental work as well as other processes. Request your physician whether you need to use antibiotics.

Some patients may need heart processes to treat mitral stenosis. Percutaneous mitral balloon valvotomy (also called valvuloplasty) may be attempted as an alternative to operation in people who have a less damaged mitral valve. During this process, a tube (catheter) is inserted into a vein, usually in the leg. It’s threaded up into one’s heart. A balloon in the tip of the catheter is inflated, widening the mitral valve and enhancing blood circulation.

Others have to have the mitral valve fixed or replaced. Replacement valves can be produced from different substances. Some may last for decades and others can wear out as well as need to be replaced.