Mitral Valve Stenosis


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Related to Mitral Valve Stenosis: Mitral valve regurgitation

Mitral Valve Stenosis

 

Definition

The term stenosis means an abnormal narrowing of an opening. Mitral valve stenosis refers to a condition in the heart in which one of the valve openings has become narrow and restricts the flow of blood from the upper left chamber (left atrium) to the lower left chamber (left ventricle).

Description

In the heart, the valve that regulates the flow of blood between the left atrium and the left ventricle is called the mitral valve. If the mitral valve is abnormally narrow, due to disease or birth defect, blood flow from the atrium to the ventricle is restricted. This restricted flow leads to an increase in the pressure of blood in the left atrium. Over a period of time, this back pressure causes fluid to leak into the lungs. It can also lead to an abnormal heart rhythm (atrial fibrillation), which further decreases the efficiency of the pumping action of the heart.

Causes and symptoms

Mitral valve stenosis is almost always caused by rheumatic fever. As a result of rheumatic fever, the leaflets that form the opening of the valve are partially fused together. Mitral valve stenosis can also be present at birth. Babies born with this problem usually require surgery if they are to survive. Sometimes, growths or tumors can block the mitral valve, mimicking mitral valve stenosis.
If the restriction is severe, the increased blood pressure can lead to heart failure. The first symptoms of heart failure, which are fatigue and shortness of breath, usually appear only during physical activity. As the condition gets worse, symptoms may also be felt even during rest. A person may also develop a deep red coloring in the cheeks.

Diagnosis

Mitral valve stenosis is usually detected by a physician listening to heart sounds. Normal heart valves open silently to permit the flow of blood. A stenotic valve makes a snapping sound followed by a "rumbling" murmur. The condition can be confirmed with a chest x ray and an electrocardiogram, both of which will show an enlarged atrium. Echocardiography, which produces images of the heart's structure, is also helpful in making the diagnosis. If surgery is necessary, cardiac catheterization may be done to fully evaluate the heart before the operation.

Treatment

Drug therapy may help to slow the heart rate, strengthen the heart beat, and control abnormal heart rhythm. Drugs such as beta blockers, calcium channel blockers, and digoxin may be prescribed. A drug that prevents abnormal blood clotting (anticoagulant) called warfarin (Coumadin) may be recommended. If drug therapy does not produce satisfactory results, valve repair or replacement may be necessary.
Repair can be accomplished in two ways. In the first method, balloon valvuloplasty, the doctor will try to stretch the valve opening by threading a thin tube (catheter) with a balloon tip through a vein and into the heart. Once the catheter is positioned in the valve, the balloon is inflated, separating the fused areas. The second method involves opening the heart and surgically separating the fused areas.
If the valve is damaged beyond repair, it can be replaced with a mechanical valve or one that is partly mechanical and partly made from a pig's heart.

Prognosis

Procedures available to treat mitral valve stenosis, whether medical or surgical, all produce effective results.

Prevention

The only possible way to prevent mitral valve stenosis is to prevent rheumatic fever. This can be done by evaluating sore throats for the presence of the bacteria that causes strep throat. Strep throat is easily treated with antibiotics.

Resources

Organizations

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. http://www.americanheart.org.

Other

The Meck Page. http://www.merck.com.

Key terms

Atrium — One of the two upper chambers of the heart.
Beta blocker — A drug that can be used to reduce blood pressure.
Rheumatic fever — An illness which sometimes follows a streptococcal infection of the throat.
Ventricle — One of the two lower chambers of the heart.
References in periodicals archive ?
Gross features are characterized by mitral valve stenosis due to commissural fusion, leaflet thickening and subvalvular disease with shortened, thickened, and often fused, chordae tendineae.
According to Mitral Valve Stenosis Market 2019 Global Industry Analysis To 2023, report on "Global Mitral Valve Stenosis Industry" published by Market Research Future, The Mitral Valve Stenosis Market Projected to Experience Major Revenue Boost By 2023.
Lutembacher Syndrome (LS) is a rare cardiac clinical entity comprising of an unusual combination of atrial septal defect (ASD) and acquired Mitral valve stenosis (usually of the rheumatic nature).1 LS is an infrequent disorder with a prevalence of 0.001 million per population, mostly occurring in females.2,3 The clinical presentation and prognosis of the disease varies depending on a multitude of factors; the most important one being the size of the defect while other factors include severity of stenosis and compliance of the right ventricle.
"For patients with heart valve conditions, such as mitral valve stenosis, or a prior history of stroke or transient ischemic attack (TIA), that risk could be quite high.
Transthoracic echocardiogram (TTE) revealed ejection fraction (EF) of 65%, severe mitral valve stenosis and mitral regurgitation, with a mean gradient of 8.5 mmHg across the mitral valve, restricted motion of mitral leaflets and thrombus across mitral valve.
Managing severe mitral valve stenosis in pregnant patients--percutaneous balloon valvuloplasty, not surgery, is the treatment of choice.
The main pathological finding was severe mitral valve stenosis with reduced mitral valve area and fusion of the commissures.
The concomitant congenital valvular abnormalities described to date consist of mitral atresia, double-orifice mitral valve, mitral valve cleft, congenital mitral valve stenosis, aortic stenosis, absent aortic valve and tricuspid atresia, which all have been primarily reported in infants and children (2,5,8).