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Mitral Stenosis

 

 

 Mitral stenosis

Mitral stenosis is a heart valve disorder that occurs when the mitral valve, located between the left atrium and the left ventricle of the heart, becomes narrow or partially blocked. This narrowing of the valve prevents normal blood flow from the left atrium to the left ventricle, resulting in various symptoms and potential complications.

Mitral stenosis is typically caused by rheumatic fever, a condition resulting from an untreated streptococcal infection (such as strep throat). Rheumatic fever can cause damage to the mitral valve, leading to the development of mitral stenosis over time.

 

The key symptoms of mitral stenosis may include:
1. Shortness of breath
2. Fatigue
3. Palpitations
4. Cough
5. Chest discomfort

Over time, untreated mitral stenosis can lead to complications, such as atrial fibrillation (an irregular heartbeat), heart failure, and pulmonary hypertension. In severe cases, it can significantly reduce a person’s ability to engage in physical activities.

Diagnosis of mitral stenosis often involves a physical examination, listening to the heart with a stethoscope, and various imaging tests, such as echocardiography, which can provide detailed information about the structure and function of the heart valves.

Treatment for mitral stenosis depends on the severity of the condition and the presence of symptoms. Common treatment options include:

1. Medications: These may be prescribed to manage symptoms, control irregular heart rhythms, and prevent complications, but they do not treat the valve narrowing itself.

2. Balloon mitral valvuloplasty(BMV): This is a procedure in which a balloon is used to open the narrowed mitral valve. It is a catheter based option that can improve blood flow through the valve. Dr.Nikhil says, “BMV is the best 1st procedure in most patients with mitral stenosis!”.

3. Mitral Valve Replacement : the mitral valve may need to be surgically replaced.

  • Open Surgery : The narrowed valve is surgically removed and replaced with a mechanical or biological valve.
  • Minimally Invasive surgery (MICS) : The narrowed valve is surgically removed and replaced with a mechanical or biological valve via a small incision.
  • Cox Maze 4 procedure : Dr.Nikhil says, “Cox Maze IV should be added to mitral valve replacement in the presence of atrial fibrillation, but is frequently omitted by surgeons!”.
  • Incisionless or Transcatheter Mitral Valve replacement (TMVR) : TMVR involves replacing the mitral valve using a catheter inserted through a blood vessel, typically in the groin. Dr.Nikhil says, “TMVR should only be done in patients with previous bioprosthetic mitral valve replacement.”

Early diagnosis and appropriate management are crucial for individuals with mitral stenosis to prevent complications and improve their quality of life. Regular follow-up is essential to monitor the condition and determine the most suitable treatment plan.