What is Mitral Valve Stenosis?

Mitral valve stenosis is a condition in which the mitral valve, which is located between the heart’s left atrium and left ventricle, becomes thick, stiff or fused. This prevents the valve from fully opening and not enough blood can flow through to the main pumping chamber of the heart.

Baptist Health is known for advanced, superior care for patients with heart problems and the diagnosis, management and treatment of mitral valve disease. The Valve Team at Baptist Health Louisville is dedicated to offering the full range of therapeutic options to patients. Our minimally invasive valve surgeries and interventional procedures have outstanding clinical outcomes and patient satisfaction. 

You will appreciate timely appointments and respectful attention to your concerns, all in a positive and friendly atmosphere. Here, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Mitral valve stenosis symptoms may be absent or mild. More serious symptoms include:

Diagnosis

To determine if a patient has mitral valve stenosis, the physician will ask questions about family history and symptoms and listen to the patient’s heart with a stethoscope. The physician will also listen for a buildup of fluid in the lungs. We use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Cardiac catheterization: During this test, a long, thin flexible tube is threaded through a blood vessel in the arm or groin and to the heart. Contrast material is injected through the tube and a type of X-ray movie is taken to show how the aortic valve functions.

Chest X-ray: X-rays are common imaging tests of the heart and aorta.

Echocardiogram: This ultrasound exam uses soundwaves to take moving pictures of the heart’s chambers and valves. 

Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.

Transesophageal echocardiogram (TEE): Similar to an echocardiogram, a small transducer is used to direct the soundwaves. The transducer is attached to the end of a tube and inserted down the esophagus, to get closer to the mitral valve than a regular echocardiogram can.

Transthoracic echocardiogram: In this test, sound waves are directed at the heart from a wand-like device (transducer) held on the chest to produce video images of the heart in motion.

Causes

Mitral valve stenosis is not usually caused by behaviors or lifestyle factors.

Risk Factors

Risk factors that could contribute to mitral valve stenosis include:

Rheumatic fever: Prompt or incomplete treatment of strep throat or scarlet fever can lead to inflammation and infection of the heart’s inner lining, damaging the heart valves. This is a common cause of mitral valve stenosis, but rare in the United States and other developed countries.

Calcium deposits: As a person ages, calcium deposits can build up around the ring around the mitral valve, which can occasionally cause mitral valve stenosis.

Congenital heart defects: Some babies are born with narrowed mitral valves.

Radiation therapy: In rare cases, radiation treatments for cancer – focused on the chest – can lead to this condition.

Autoimmune diseases: In rare cases, conditions such as lupus can lead to mitral valve stenosis.

Prevention

Most risk factors for mitral valve stenosis cannot be prevented.

Prognosis

Mitral valve stenosis can often have few to no symptoms and may only require monitoring. When symptoms worsen, treatment can control symptoms and improve the function of the valve.

Treatment and Recovery

Treatment for mitral valve stenosis depends on the severity of the condition, and may include:

Medication

Medication can’t correct valve damage or defects, but some can help the symptoms. Depending on your symptoms and the severity of your condition, your doctor may prescribe medications to treat atrial fibrillation, prevent recurrence of rheumatic fever, prevent blood clots, lower blood pressure or remove excess fluid from the body.

Surgery

Surgery is often recommended to repair or replace the affected heart valve. Depending on your health and the condition of your valve, you may have the valve repaired or replaced in a minimally invasive procedure or a more extensive, open surgery.

Procedures to repair a mitral valve can include:

• Valvuloplasty, in which a surgeon attaches a small ring-like device around the outside of the valve opening to provides more support to the mitral valve.
• Commissurotomy, in which the surgeon removes calcium deposits and scar tissue to clear the valve’s opening.

If valve replacement is necessary, your surgeon will remove some or all of your valve and replace it with one of two types of valves:

• Mechanical valve, which is made from metal. If you have a mechanical valve, you will need to take blood-thinning medication for the rest of your life.
• Biological valve, which is made of human or animal tissue.

Depending on the type of surgery you have, recovery after valve surgery can take a long time. Your activities will be limited, you will experience some physical and emotional changes during recuperation, and you may have problems such as chest pain or trouble sleeping.

Complications

Left untreated, mitral valve stenosis can strain the heart and decrease blood flow, leading to complications like:

Atrial fibrillation: This heart rhythm irregularity can cause blood clots, which can break loose from your heart and travel to other parts of your body. This can lead to a stroke if it cuts off blood supply to the brain.

Heart enlargement: The pressure buildup of mitral valve stenosis results in enlargement of the heart’s left atrium.

Heart failure: This occurs when the heart can't pump enough blood to meet the body's needs

Lung congestion (pulmonary edema):  Blood and fluid can back up into the lungs, leading to shortness of breath and, sometimes, coughing of blood-tinged sputum.

Pulmonary hypertension: This type of high blood pressure affects the vessels in the lungs, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms.