Mitral Valve Disease

Mayo Clinic: Mitral Valve Stenosis

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Mitral valve stenosis, (mitral stenosis) is a narrowing of the mitral valve. With narrowing, the valve does not open properly and obstructs blood flow between the left chambers of the heart.

If not treated, mitral stenosis can weaken the heart, lead to heart failure or heart enlargement, and cause irregular heartbeats. Other potentially serious complications can include stroke, heart infection, pulmonary edema (water on the lungs) and blood clots.

Within a few days, a team of heart valve disease specialists at Mayo Clinic coordinates the patient's care to provide a complete examination, diagnosis and extensive patient education. These specialists see patients ranging from those who might want to have a heart murmur checked, to those who have been told they have advanced mitral heart valve disease.

If surgery is indicated, a cardiac surgeon meets with the patient to thoroughly discuss surgical options and, in most cases, can perform the surgery the following day — depending on the patient's preference. Mayo Clinic is a major medical center that conducts clinical trials and research on various aspects of heart valve disease, and some patients may be eligible to participate in clinical trials or research programs.

Symptoms

Signs and symptoms of mitral stenosis depend on how severely and quickly the condition develops. Some people never develop symptoms. Some have mild problems that suddenly get worse. Signs and symptoms of mitral stenosis include:

• Shortness of breath, especially with physical exertion (exercise) or when the person lies down
• Fatigue, especially during increased activity
• Swollen feet or ankles
• Heart palpitations — sensations of a rapid, fluttering heartbeat
• Dizziness or fainting spells
• Frequent respiratory infections, such as bronchitis
• Heavy coughing, sometimes with blood-tinged sputum
• Rarely, chest discomfort or chest pain

Causes

The mitral valve can narrow because of conditions that include:

Rheumatic fever

This now-rare (in the United States) complication of strep throat was once a common childhood illness. It can damage the mitral valve, leading to mitral stenosis later in life. In some people, the body's response to the strep throat infection leads to mitral valve damage that causes the valve to become inflamed, thicken, and leak (mitral regurgitation). This inflammatory process can cause the valve to fuse and harden, resulting in mitral stenosis. People who have had rheumatic fever may have both mitral stenosis and mitral regurgitation. Many older adults in the United States were exposed to rheumatic fever as children. In developing countries, rheumatic fever is the leading cause of mitral valve disease.

Congenital heart defect

Some infants are born with a narrowed mitral valve and develop mitral stenosis early in life. Babies born with this problem usually require heart surgery to fix the valve. Others are born with a malformed mitral valve and have a risk of developing mitral stenosis when they're older.