Mitral stenosis Health Article

Signs and tests

The health care provider will listen to the heart and lungs with a stethoscope. A distinctive murmur, snap, or other abnormal heart sound may be heard. The typical murmur is a rumbling sound that is heard over the heart during the resting phase of the heartbeat. The sound gets louder just before the heart begins to contract.

The exam may also reveal an irregular heartbeat or lung congestion. Blood pressure is usually normal.

Narrowing or obstruction of the valve or swelling of the upper heart chambers may show on:

• Cardiac catheterization
• Chest x-ray
• Doppler ultrasound
• Echocardiogram
• ECG (electrocardiogram)
• MRI of the heart
• Transesophageal echocardiogram (TEE)

Treatment

Treatment depends on the symptoms and condition of the heart and lungs. People with mild symptoms or none at all may not need treatment. Hospitalization may be required for diagnosis and for treatment of severe symptoms.

There are a number of different treatment options.

Medications are used to treat symptoms of heart failure or abnormal heart rhythms (most commonly atrial fibrillation). These include diuretics (water pills), nitrates, beta-blockers, and others. High blood pressure should also be treated.

Anticoagulants (blood thinners) are used to prevent blood clots from forming and traveling to other parts of the body.

Some patients may need heart surgery to repair or replace the valve. Replacement valves can be made from different materials, some of which may last for decades and others which can wear out and require replacement.

Percutaneous mitral balloon valvotomy (also called valvuloplasty) may be considered instead of surgery. During this procedure, a catheter (tube) is inserted into a vein, usually in the leg, and up into the heart. A balloon on the tip of the catheter is inflated, widening the mitral valve and improving blood flow. This procedure is less likely to work in patients with severely damaged mitral valves.

Children often require surgery to either repair or replace the mitral valve.

People with mitral stenosis should inform their health care provider of their condition before any procedures or surgeries. Dental work, including cleaning, and any invasive procedure, such as colonoscopy, can introduce bacteria into the bloodstream. These bacteria can infect a damaged heart valve. Although patients with valve problems are no longer automatically given antibiotics before any dental or other procedure, antibiotics may still be recommended in certain cases to help decrease the risk of valve infection and complications.

See also:

• Heart failure
• Mitral valve surgery - minimally invasive
• Mitral valve surgery - open