Overview
Mitral valve stenosis is a condition where the valve between the two left heart chambers (mitral valve) narrows, reducing or blocking blood flow into the heart's main pumping chamber (left ventricle). It can cause symptoms such as shortness of breath, fatigue, irregular heartbeats, dizziness, chest pain, or coughing up blood. Mitral valve stenosis can be caused by a complication of strep throat called rheumatic fever, which is now rare in the United States. Treatment may include medication, mitral valve repair or replacement surgery, or regular health checkups, depending on the severity of the condition and whether it's getting worse. Untreated, mitral valve stenosis can lead to serious heart complications.
Understanding the disease
Symptoms
Symptoms of mitral valve stenosis include shortness of breath, especially with activity or when you lie down, fatigue, especially during increased activity, swollen feet or legs, sensations of a fast, fluttering or pounding heartbeat, dizziness or fainting, irregular heart sound, also called a heart murmur, fluid buildup in the lungs, and chest discomfort or chest pain. These symptoms may appear or get worse when the heart rate increases, such as during exercise. If you experience chest pain, a fast, fluttering or pounding heartbeat, or shortness of breath during activity, you should call your healthcare provider for an immediate appointment.
Risk Factors
Risk factors for developing mitral valve stenosis include:
- Untreated strep infections. A history of untreated strep throat or rheumatic fever increases the risk of mitral valve stenosis.
- Aging. Older adults are at increased risk of calcium buildup around the mitral valve.
- Radiation therapy. Radiation causes changes in the mitral valve shape and structure. Rarely, people who receive radiation therapy to the chest area for certain types of cancer may develop mitral valve stenosis.
Development
Mitral valve stenosis can develop due to several causes, including:
- Rheumatic fever: This is the most common cause of mitral valve stenosis. It is a complication of strep throat, and it can damage the mitral valve. The symptoms may not appear until years or decades after the rheumatic fever.
- Calcium deposits: As people age, calcium deposits can build up around the mitral valve, causing narrowing of the structures that support the mitral valve flaps. This is known as mitral annular calcification (MAC). Severe MAC can lead to mitral stenosis symptoms and is difficult to treat, even with surgery.
- Radiation therapy: This is a treatment for certain types of cancer. Radiation to the chest area can sometimes cause the mitral valve to thicken and harden. The heart valve damage typically occurs 20 to 30 years after radiation therapy. These are the main causes of mitral valve stenosis. It's essential to consult a healthcare provider for proper diagnosis and management of the condition.
Assessment and Diagnosis
Triage
You should see a doctor for an immediate appointment if you experience chest pain, a fast, fluttering or pounding heartbeat, or shortness of breath during activity, which are symptoms of mitral valve stenosis. Additionally, if you have been diagnosed with mitral valve stenosis but haven't had symptoms, ask your provider about how often you should have follow-up exams.
Diagnosis
To diagnose mitral valve stenosis, a healthcare provider will typically begin with a physical exam that includes listening to the heart with a stethoscope to detect any irregular heart sounds or heart murmurs. They will also ask about the individual's symptoms, medical history, and family history. If necessary, further diagnostic tests may be ordered, such as chest X-rays, electrocardiograms (ECG), exercise stress tests, cardiac CT, cardiac MRI, or echocardiogram. These tests can help confirm the diagnosis of mitral valve stenosis and determine its severity and impact on heart function.
Management and Treatment
Complications
Potential complications of mitral valve stenosis include enlargement of the left heart chamber, heart failure, atrial fibrillation, pulmonary hypertension, and in severe cases, coarctation of the aorta. Untreated, mitral valve stenosis can lead to serious heart complications.
Prevention
Mitral valve stenosis can be prevented by preventing the most common cause, which is rheumatic fever. One way to prevent rheumatic fever is to ensure that you and your children see a healthcare provider for sore throats, as untreated strep throat infections can develop into rheumatic fever. Strep throat is usually easily treated with antibiotics.
Home Remedies
It's important to note that while home remedies may provide temporary relief, managing mitral valve stenosis typically requires medical intervention. Consult your healthcare provider for proper treatment and management of the condition.
Treatment
Treatment for mitral valve stenosis may include medication, mitral valve repair or replacement surgery, or regular health checkups, depending on the severity of the condition and whether it's getting worse. Medications can help manage symptoms and prevent blood clots. In severe cases, surgery might be necessary to repair or replace the narrowed valve. Mitral valve stenosis can lead to serious heart complications if left untreated. Prevention of mitral valve stenosis involves treating streptococcal infections with antibiotics to prevent rheumatic fever, which is the most common cause of this condition.
Preparing for medical consultation
To prepare for an appointment for mitral valve stenosis, you should:
- Write down your symptoms: Make a list of all the symptoms you are experiencing, even if they seem unrelated to mitral valve stenosis.
- Gather personal information: Note any family history of heart disease, heart defects, genetic disorders, stroke, high blood pressure, or diabetes. Also, consider any major stresses or recent life changes that might be relevant.
- Bring a list of medications, vitamins, and supplements: Be prepared to share the list with your healthcare provider.
- Bring a family member or friend: If possible, bring someone along to help remember information and discuss your health concerns.
- Discuss your diet and exercise habits: Be ready to talk about your diet and exercise routines, as well as any challenges you may face in starting or maintaining a healthy lifestyle.
- Prepare questions: Write down a list of questions to ask your healthcare provider about your condition, tests, treatments, and any other concerns you may have.
- Expect your healthcare provider to ask questions: They will likely ask about your symptoms, when they began, their frequency, and any other relevant information.
- Follow any pre-appointment restrictions: If your healthcare provider tells you to restrict your diet or perform any other preparations before the appointment, make sure to follow them. By being well-prepared and actively participating in your appointment, you can better understand your condition and work with your healthcare provider to develop an appropriate treatment plan.