Mitral stenosis is a narrowing of the mitral valve in the heart. This valve is located between the upper chamber and the lower pumping chamber of the left side of the heart. Blood must flow from the atrium, through the mitral valve, and into the ventricle before being pumped out into the rest of the body. Mitral stenosis can result in poor blood flow between the 2 left chambers, which can affect how much blood and oxygen is getting to the body's organs and tissues.
Mitral Valve Stenosis
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The most common cause of mitral stenosis is
, which scars the mitral valve. Less commonly, there are some
congenital heart defects
which may affect the mitral valve and its function. Very rare causes include
, blood clots, tumors, or other growths that block blood flow through the mitral valve.
Mitral stenosis is more common in women, and most often appears in adults between the ages of 30 and 50 years old. Other factors that may increase your chance of mitral stenosis include: History of rheumatic fever or recurrent strep infectionsCongenital abnormality of the valveFamily history
Other chronic conditions, such as
chronic kidney disease
coronary artery disease
History of radiation treatment to the chestIV drug use
Mitral stenosis may cause: Difficulty breathing, especially during exercise and when lying flatAwakening short of breath in the middle of the nightFatigueSensation of rapid or irregular heartbeatCough with exertionCoughing up bloodSwelling of the legs or feetFrequent respiratory infectionsLightheadedness, faintingRarely, chest pain, such as squeezing, pressure, or tightness
If you have mild mitral stenosis, your condition will need to be monitored, but you may not need immediate treatment for symptoms associated with mitral stenosis. When symptoms become more severe, you may need more aggressive treatment, which may include avoiding exertion and high-salt foods.
Although no longer routinely recommended, you may need to take antibiotics prior to some dental and medical procedures. This is to prevent heart infections. Ask your doctor if you will need to take antibiotics.
Treatment may include:
Drugs may be prescribed to treat specific symptoms associated with mitral stenosis. These medications include: Drugs that lower the heart rate and improve the heart's functionDiureticsBlood-thinning drugs
Drugs to control heart
You may also need to take antibiotics when you have certain infections. This will help prevent further damage to your heart.
Common types of heart valve surgery include: Mitral valvulotomy—A surgical cut or enlargement is made in the stenotic mitral valve to relieve the obstruction.Balloon valvuloplasty
—A balloon device is inserted into the blocked mitral valve to open or enlarge the valve. This may provide temporary relief of symptoms. However, the valve may become blocked again.
Mitral valve replacement
—This is the surgical replacement of a defective heart valve. This surgery is usually delayed until symptoms are severe or the patient can no longer be helped by other procedures.
To reduce your chance of mitral stenosis or its complications:
Get prompt treatment for any infections, especially
Talk to your doctor about prophylactic antibiotic treatment to prevent recurrent strep infections.Follow any treatment plans to manage chronic health conditions.Avoid excess caffeine and alcohol, and all illicit drugs that speed up your heart rate.Exercise regularly and monitor your salt intake.
Fauci AS, Braunwald E, et al.
Harrison's Principles of Internal Medicine. 14th ed. New York, NY: The McGraw-Hill Companies; 2000.
Premedication (antibiotics). American Dental Association's Mouth Healthy website. Available at:
http://www.mouthhealthy.org/en/az-topics/p/Premedication-or-Antibiotics.aspx. Accessed August 20, 2014.
and Wahba H. Valvular heart disease: review and update.
Am Fam Physician. 2001;63:2201-2208.
Last reviewed August 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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