Mitral Stenosis Adult

Causes

The most common cause of mitral stenosis is rheumatic fever, because it can scar the mitral valve. Some congenital heart defects may also affect the mitral valve and how well it works.

Less common causes of this problem include:

• Bacterial endocarditis
• Blood clots
• Tumors or growths that block blood flow

Risk Factors

Mitral stenosis is more common in women. It often appears in adults between of 30 and 50 years of age. Other things that may raise the risk of mitral stenosis are:

• A history of rheumatic fever or a lot of strep infections
• Heart valve problems present at birth
• A family history of mitral stenosis
• Other health problems, such as high blood pressure, chronic kidney disease, and coronary artery disease (CAD)
• A history of radiation treatment to the chest
• IV drug use

Symptoms

Mitral stenosis may cause:

• Trouble breathing, especially while working out and when lying flat
• Waking up short of breath in the middle of sleeping
• Tiredness
• Fast or irregular heartbeat
• Cough when doing something that takes effort
• Coughing up blood
• Swelling of the legs or feet
• Lightheadedness and fainting
• Chest pain, such as squeezing, pressure, or tightness (rare)

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the chest and heart.

Pictures will be taken of the heart and chest. This can be done with:

• X-ray
• Echocardiogram
• Transesophageal echocardiogram
• Cardiac catheterization

The heart's electrical activity may be tested. This can be done with:

• ECG
• Holter monitor—This is worn on the body to measure heart activity over 1 or 2 days

Treatment

The goals of treatment are to manage symptoms and make sure the heart rate stays in a healthy range. People with mild mitral stenosis may only need monitoring. If symptoms get worse the doctor may advise avoiding intense activity and foods that have a lot of salt.

Treatment options are:

Supportive Care

Some steps that may be advised to manage mitral stenosis include:

• Limiting salt intake
• Limiting caffeine and alcohol
• Physical activity

Medications

Medicines can help manage symptoms. The doctor may advise:

• Medicines that lower the heart rate and help the heart work better
• Diuretics to prevent fluid buildup
• Blood thinners
• Drugs to control heart rhythm

Antibiotics may need to be taken for certain infections. This will help prevent more harm to the heart. They may also be needed before medical and dental procedures.

Surgery

Common types of heart valve surgery are:

• Mitral valvulotomy—The stenotic mitral valve is cut to ease the obstruction.
• Balloon valvuloplasty—A balloon device is put into the blocked mitral valve to open it or make it bigger.
• Mitral valve replacement—This is for people with severe symptoms or when other treatments have not helped.

Prevention

To lower the risk of mitral stenosis:

• Get treated right away for any possible infections, especially strep throat.
• Manage chronic health problems.