Mitral stenosis is a heart valve condition that develops when the mitral valve, which connects the left atrium and left ventricle of the heart, is narrowed or partially blocked. The constriction of the valve limits normal blood flow from the left atrium to the left ventricle, causing a variety of symptoms and possible problems.
This restriction affects the natural flow of blood, resulting in a variety of symptoms and serious problems. Fatigue, shortness of breath, and irregular heartbeats are common symptoms of mitral stenosis, and they can have an immense impact on one’s quality of life.
What are the causes of Mitral Stenosis?
Rheumatic fever, which is caused by an untreated streptococcal infection, is the most common cause of mitral stenosis. Rheumatic fever can damage the mitral valve, resulting in the development of mitral stenosis over time. A consequence of strep throat may injure the mitral valve, causing it to thicken and narrow.
Other factors are:
- Age: Calcium deposits might accumulate on the valve over time.
- Radiation therapy: Treatment for certain types of cancer may cause the valve to thicken and stiffen.
- Congenital Heart Defects: In rare situations, persons may be born with a narrowed mitral valve.
- Calcification of the mitral valve leaflets
- Malignant carcinoid syndrome
- Systemic lupus erythematosus
- Whipple disease
- Fabry disease
- Rheumatoid arthritis
What are the symptoms of Mitral Stenosis
Mitral valve stenosis usually develops gradually, with no apparent symptoms for many years. However, symptoms can emerge at any age, including childhood. The warning signs of mitral valve stenosis are:
- Difficulty breathing, particularly during vigorous exercise or resting down.
- Prolonged weariness, especially during exertion
- Swelling in your feet or legs
- Fast, fluttering, or throbbing heartbeats
- occurrences of dizziness or fainting.
- Abnormal heart sounds, often known as heart murmurs
- Fluid accumulation in the lungs causes breathing difficulty.
- irregular heart rhythms, like atrial fibrillation.
- Chest discomfort or pain.
- Hemoptysis or, coughing up blood.
Mitral valve stenosis can cause severe complications if it is not diagnosed and treated properly. These include atrial fibrillation, which raises the risk of blood clots and stroke. It can even cause pulmonary hypertension, in which high blood pressure compromises the arteries in the lungs, and heart failure as a result of higher stress on the heart.
Proper diagnosis and treatment are critical for treating the illness and avoiding possible negative effects. Regular check-ups and monitoring by a medical professional can assist patients with mitral valve stenosis to manage their symptoms and enhance their quality of life.
Diagnosis of Mitral Stenosis
For the diagnosis of mitral valve stenosis, your healthcare professional will first listen to your heart and lungs with a stethoscope. They may hear a murmur, snap, or other unconventional cardiac sounds. Typically, the murmur associated with mitral stenosis is a rumbling noise heard during the resting period of the heartbeat. But it becomes louder shortly before the heart contracts.
In the course of the examination, the doctor may notice an erratic pulse or symptoms of lung congestion, but blood pressure generally remains normal.
A variety of imaging studies can be used to confirm the diagnosis and determine the severity of the condition:
- Chest X-rays: Can detect valve narrowing or obstruction, as well as enlargement in the upper heart chambers.
- Echocardiograms: Use sound waves to produce detailed images of the heart, revealing valve structure and blood flow.
- Electrocardiogram (ECG): measures the electrical activity of the heart and can detect irregular heartbeats.
- MRI or CT scan: Produces detailed images of the heart’s anatomy and any anomalies.
- Transesophageal Echocardiogram (TEE): An echocardiogram obtained from within the esophagus that provides a more detailed image of the heart valves.
These diagnostic methods allow your medical professional to assess the extent of the valve narrowing. It ultimately helps in planning the most effective course of action to manage your symptoms and avoid problems.
Treatment for Mitral Stenosis
Treatment will be determined by the symptoms and the overall condition of the heart and lungs. People who have minor or no symptoms may not require treatment. If you have serious symptoms, you may need to visit the hospital for diagnosis and treatment.
1. Medications: These may be recommended to relieve symptoms, control abnormal cardiac rhythms, and avoid concerns. However they do not address the valve narrowing. Heart failure symptoms, high blood pressure, and slowing or regulating heart rhythms can be treated with the following medications:
- Diuretics (water pills).
- Nitrates and Beta-blockers
- Calcium Channel Blockers
- ACE inhibitors
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.
BMV is the best 1st procedure in most patients with mitral stenosis!
Dr. Nikhil
Balloon mitral valvuloplasty can minimize symptoms such as chest pain, shortness of breath, heart failure, blood clots, and stroke. It is useful for treating stiff and calcified valves caused by inflammation, infection, or congenital cardiac abnormalities.
The technique is an inpatient procedure that lasts around an hour and requires anesthesia. Balloon mitral valvuloplasty has a success rate of around 93% and a lower prevalence of complications and post-operative infections than closed mitral commissurotomy.
3. Incisionless or Transcatheter Mitral Valve Replacement (TMVR): The mitral valve is replaced using a catheter implanted into a blood vessel, usually in the groin.
TMVR should only be done in patients with previous bioprosthetic mitral valve replacement.
Dr. Nikhil
There are two types of TMVR techniques:
i) Native valve replacement: Replaces the original mitral valve.
ii) Valve-in-valve: Replaces a faulty prosthetic valve or fixes a failing ring from a previous surgery.
TMVR is FDA-approved for high-risk patients who are not suitable for surgery, such as the elderly and those with several chronic diseases. Patients normally return home the next day and continue their normal activities. Full recovery can take two to three months. Blood clots, tissue damage, and an obstruction of the left ventricular outflow tract are all possible complications.
Early diagnosis and appropriate treatment of mitral stenosis are critical for avoiding complications and improving quality of life. Individuals with this medical condition should have regular follow-up appointments to evaluate their heart health.
These check-ups help in determining the development of the condition while planning the most favorable treatment plan. Regular evaluation ensures that treatment alterations are made on time, thereby lowering the risk of serious consequences.
Schedule your consultation today for TAVR/TMVR and other treatments for Cardiac care at Heart360 Care. Our expert Dr. Nikhil P.J.Theckumparampil is a Gold medalist in MBBS with 17 years of experience in the U.S. He is trained and published on LVAD and heart transplantation.
