Mitral Valve Stenosis

What Is Mitral Valve Stenosis?

Mitral valve stenosis is a valvular heart disease that can affect people of all ages, although the reasons vary depending on when and why it develops. Also referred to as mitral stenosis, this condition occurs when the mitral valve becomes narrowed, restricting blood flow from the main pumping chambers.

Read on for clear information about mitral valve stenosis, its symptoms, and the best treatment options.

What Is the Mitral Valve & Why Does It Matter?

The mitral valve is one of four valves in the heart chambers. It is located between the left atrium and the left ventricle on the left side of the heart, controlling blood flow from your lungs to the rest of your body.

This two-leaflet valve opens when your heart relaxes, allowing oxygen-rich blood to fill the left ventricle. When your heart contracts to pump blood through blood vessels to your organs, the valve leaflets snap shut to prevent backflow.

Overview of Mitral Valve Stenosis

Mitral Valve Stenosis is a narrowing of the valve, a condition involving thickening and calcification of the mitral valve, which causes the valve to fail to open properly.

This impedes the movement of blood from the left atrium to the left ventricle, which results in poor blood flow to the rest of the body. The left atrium thickens and dilates, and the blood pressure in the lung arteries starts to rise.

This can encourage abnormal heart rhythm disorders like atrial fibrillation, which may present with heart palpitations, to develop, further reducing the efficiency of the heart. Many of these secondary problems become permanent over time and should be avoided by early intervention.

Mitral Valve Stenosis Causes

There are various causes of mitral valve stenosis.

Rheumatic Fever

Rheumatic fever is the most common cause of mitral stenosis, resulting from the body’s immune response to an infection in childhood. When caused by rheumatic fever, it is also called rheumatic mitral stenosis.

As the prevalence of rheumatic fever declines, rheumatic mitral stenosis has become less common in developed countries. However, it still represents 10% of left-sided valve disease in Europe.

Calcium Buildup

In older adults, calcium can build up around the ring of the valve, a condition known as mitral annular calcification (MAC). Over time, severe MAC may extend to the valve leaflets and restrict their movement. This form is more common in people with high blood pressure or atherosclerosis.

Radiation Therapy

Treatment for certain types of cancer that require radiation to your chest area can sometimes cause the valve to thicken and harden.

Congenital Defects

In rare cases, people can be born with a narrowed mitral valve, which can cause problems over time. These cases are rare and often found in early life.

Other, less common causes of mitral valve stenosis include:

• Inflammatory diseases, e.g., systemic lupus erythematosus
• Infiltrative diseases
• Carcinoid heart disease
• Drug-induced valvular disease

Mitral Valve Stenosis Symptoms

Much like with many other heart conditions, such as coronary artery disease, some of the most common symptoms of mitral valve stenosis are:

• shortness of breath while doing normal activities
• chest pain
• fatigue
• irregular heartbeat

However, some symptoms that are particular to this condition are:

• swollen feet or legs
• coughing up blood
• fluid buildup in the lungs

If you experience any of these mitral valve stenosis signs and symptoms, it is essential that you get a medical checkup as soon as possible.

We offer a heart screening service that involves a few simple, non-invasive tests to assess your current condition and identify any irregularities or heart valve damage. From here, we will be able to offer advice on treatment.

Potential Mitral Stenosis Complications

Like other heart valve issues, this type of stenosis can put strain on your heart muscle and decrease blood flow. If left untreated, mitral valve stenosis can lead to complications such as:

• Pulmonary hypertension – refers to high blood pressure in the lung arteries, which causes your heart to work harder.
• Pulmonary oedema – blood and fluid build up in your lungs, causing shortness of breath, and you may cough up blood-tinged mucus.
• Right-sided heart failure – the narrowing of the mitral valve will interfere with blood flow, so pressure may increase in the lungs, leading to fluid build-up. This puts a strain on the right side of the heart, potentially leading to heart failure.
• Atrial fibrillation – this heart rhythm problem may be caused by the stretching and enlargement of the heart’s left atrium, which causes the upper chambers of your heart to beat chaotically.
• Blood clots – blood clots could form in the upper left chamber of your heart or break loose and travel to other parts of the body, causing serious problems, such as a stroke.

Mitral Valve Stenosis Treatment

Your mitral valve stenosis treatment options will depend on the severity of your condition. Whether you developed mitral valve stenosis from rheumatic heart disease or other causes can also influence the type of treatment recommended and the timing of intervention.

Mild Mitral Valve Stenosis: Drug Therapies

Doctors typically prescribe diuretics and anticoagulants to relieve symptoms of mild to moderate mitral valve stenosis. Diuretics (water tablets) are useful in the medical treatment of heart failure associated with mitral stenosis.

Drugs like Digoxin are used to control the rate of atrial fibrillation. Medical therapy can sustain patients for many years since the progression of mitral valve disease is slow.

Severe Mitral Valve Stenosis: Keyhole Surgery

Surgical treatment is the best option for advanced mitral valve stenosis. Surgeons first successfully treated severe mitral stenosis in the 1920s, making it the earliest heart valve disorder corrected this way.

At the Keyhole London Heart Clinic, we would always recommend a minimally invasive keyhole approach in order to minimise pain, scarring and recovery time for the patient.

There are a few kinds of surgery that can be used as treatment, including keyhole mitral valve repair or replacement. Valve replacement is a good treatment for this type of condition once significant shortness of breath develops.

Our preferred method of treatment is to perform keyhole mitral valve replacement through a small cut between the ribs on the right side of the chest in suitable candidates without cutting or spreading the ribs. Keyhole mitral valve stenosis surgery should only be undertaken by highly skilled surgeons, as it requires very precise surgery.

However, keyhole surgery, compared to traditional open-heart surgery, means the patient heals in a matter of days rather than in weeks. The scar is much smaller, more subtle and concealed, and because there is no breastbone break, the patient is in less pain, there is little risk of bone infection, and there is much less bleeding.

Below is a diagram of where the keyhole incision might take place:

Help the people who care about you understand mitral stenosis and related heart problems with our videos created for clarity and peace of mind.

Mitral Stenosis FAQs

Read our expert answers to common questions on mitral valve stenosis.

How is mitral stenosis diagnosed?

There are a range of ways to test for stenosis in the mitral valve, but the first step your doctor will take is to understand your medical history and perform a physical exam.

This will involve listening to your heart with a stethoscope for a heart murmur, and your lungs for a buildup of fluid. From there, your cardiologist will decide which tests are needed to make a diagnosis.

This could include:

• Electrocardiogram (measures the electrical activity of the heart)
• Chest X-ray
• Transthoracic echocardiogram
• Transoesophageal echocardiogram
• Cardiac catheterisation

When should I get mitral valve stenosis treatment?

If you have mild to moderate stenosis without developing symptoms, you may not need immediate treatment. Instead, your doctor will usually monitor the valve to see if your condition worsens.

However, if you do start to experience symptoms regularly, you should seek medical help to prevent complications. To avoid waiting too long for an appointment, we can offer you a mitral valve heart screening and advice on the next steps to take.

Can mitral valve stenosis go away?

Once the mitral valve has become narrowed and calcified, it is unlikely that it will heal or repair itself. This is typically a lifelong heart disease that progresses over time.

In the early stages, you may experience mild symptoms or no symptoms at all, but as it progresses, the left atrium may become more damaged, causing more severe symptoms. While the mild symptoms may be able to be managed with certain drugs, monitoring and a healthy diet and lifestyle, the best course of action for the later stages is keyhole heart surgery.

Have any questions about our mitral valve stenosis treatment at The Keyhole Heart Clinic? Please feel free to get in contact with us.

The Keyhole Heart Clinic: Private Heart Surgery in the UK

The Keyhole Heart Clinic offers the kind of advanced treatment that once felt far off, but is now available to you. Our clinic is led by Mr. Inderpaul Birdi, a cardiothoracic surgeon with over twenty years of experience helping patients through complex heart procedures.

Mr. Birdi specialises in keyhole cardiac procedures, which use smaller incisions than traditional surgery. These include:

• Keyhole coronary bypass surgery
• Keyhole tricuspid valve replacement
• Keyhole aortic valve replacement
• Keyhole atrial fibrillation ablation
• Keyhole atrial septal defect closure

Get a second expert opinion on your treatment for mitral valve stenosis. Schedule your appointment with The Keyhole Heart Clinic today and take the next step toward better heart health.