Mitral Valve Stenosis

1 What is Mitral Valve Stenosis?

A narrowing of the heart’s mitral valve is called Mitral valve stenosis that occurs when the valve doesn’t open properly that may result to blocking of the blood flow into the main pumping chamber of our heart or left ventricle.

This disease can make you feel tired and out of breath.

The main cause of this is an infection called Rheumatic fever that is related to strep infections which may cause a scar in the mitral valve that is rare in the United States but still developing in other countries.

Mitral valve stenosis can lead to serious complications if left untreated.

2 Symptoms

Some of the symptoms that you can feel if you have mitral valve stenosis are:

  • out of breath when you are exercising or lying down,
  • swollen legs or feet,
  • fatigue when doing physical activities,
  • heart palpitations when you feel a sensation of rapid fluttering heartbeat,
  • severe headache,
  • fainting,
  • dizziness,
  • chest pain,
  • heavy coughing sometimes with blood,
  • trouble speaking or other symptoms of stroke.

This may happen during exercise or because of pregnancy or stress like infection and this is common in between the ages of 30-50 but can occur at any age even childhood. Pressure that builds up in the heart is then sent back to the lungs resulting in congestion and shortness of breath.

Your doctor may test you and the result maybe:

  • fluid buildup in the lungs;
  • heart murmur or irregular heart rhythms or arrhythmias.

If you suspect that you have mitral valve stenosis or neither you’re experiencing nor doesn’t have any symptoms, set an appointment with your doctor to further investigate.

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3 Causes

The causes of mitral valve stenosis are:

  • Rheumatic fever which is a complication of the strep throat that can damage the valve that can damage the mitral valve by causing flaps to fuse or thicken,
  • calcium deposits as it builds up around the ring around the mitral valve or annulus,
  • congenital defect meaning the baby are born with a narrowed mitral valve,
  • radiation to the chest,
  • autoimmune disease like lupus.

The heart consists of four chambers (the two upper chambers or atria which receive blood and the two lower chambers or ventricles that pumps blood) is the center of our circulatory system which the four heart valves open and close to let the blood flow in only one direction through your heart. The mitral valve comprises two flaps of tissue called leaflets that lies between the two chambers on the left side of your heart. The flaps will close so the blood that passed into the left ventricle will prevent from flowing backwards, if a heart valve fails to open or close it is defective.

4 Making a Diagnosis

Making a diagnosing of mitral valve stenosis is done by performing several tests.

Visit your doctor and he may refer you to a cardiologist. You may bring a family member or a close friend in order for them to help you with relevant information and to support you. Bring a notebook so that you can list all the things that you want to ask the doctor or things that he will tell you. You can also list down the symptoms that you are experiencing and the medications, supplements or vitamins that you are taking every day and you may write down the medical conditions that you had and family history.

You can ask these questions:

  • What is causing my symptoms?
  • What tests do I need?
  • Should I see a specialist?
  • Do I have any restrictions?
  • What treatment do you recommend?

When seeing a cardiologist, here are some of the questions that you can ask:

  • What is my diagnosis?
  • Does the treatment have side effects?
  • Is there a long term risk?
  • How will you monitor my condition?
  • Are there any restrictions?
  • What lifestyle changes should I make?
  • Will physical activities risk any complications?
  • I have these other problems so how can I manage these?

Your doctor may ask you questions such as:

  • What are your symptoms?
  • When did it begin?
  • Are you coughing blood?
  • Do you have any family history?
  • Are you planning to become pregnant?
  • Do you have any symptoms like fluterring or pounding heartbeats?
  • If you are exercising, did it worsen your condition?
  • Have you been diagnosed with Rheumatic fever?
  • Do you have a family history for heart problems?
  • Have you been treated for nay medical or health conditions?
  • Do you smoke? If so, how much intake?
  • Do you drink alcohol or coffee? How much intake?

Before seeing your doctor, you should ask your relatives if any of them had been diagnosed with mitral valve disease or any heart problems.

Your doctor will listen to your heart through stethoscope so that he will hear if you have an abnormal heart sound called heart murmur, he will also listen through your lungs if you have lung congestion. He will ask about medical history and will most likely give you a physical exam.

Some tests for mitral valve stenosis includes:

  • Transthoracic echocardiogram to produce video images of your heart in motion from a sound wave directed at your heart from a wand-like device called transducer;
  • Electrocardiogram to provide information about your heart rhythm which uses electronodes attached on pads, this may be done by pedaling a stationary bike or walking on a treadmill to see if your heart will respond to extortion;
  • Chest x-rays to see your lungs and to check your heart if there is any enlargement;
  • Transesophageal echocardiogram to look closer at the mitral valve that uses a small transducer that is attached to the end of the tube inserted down your esophagus;
  • Cardiac catheterization that uses a thin tube or catheter through a blood vessel in your arms to an artery of your heart so the doctor can see the artery on the X-ray.

These tests reveals the cause of your mitral valve stenosis as well as it can distinguish from other heart conditions.

5 Treatment

There are no medications for mitral valve stenosis treatment. There are certain drugs that can reduce the symptoms by easing regulating the rhythm of your heart and easing its workload such as:

  • Diuretics to reduce fluid in your lungs,
  • blood thinners or anticoagulants to prevent blood clots,
  • beta blockers which is also called calcium channel blockers to allow you heart to fill more effectively and to slow the heart rate,
  • anti-arrhythmics to treat other rhythm disturbances,
  • antibiotics to prevent Rheumatic fever.

There may be some procedures to do to repair your valve such as:

  • balloon valvuloplasty a non-surgical procedure that uses a catheter tipped with a balloon wherein it is inflated to widen the valve to improve your blood flow, after widening the valve, the balloon will be deflated and will remove the catheter,
  • commissurotomy a surgical option which means that you will be put on a heart-lung bypass machine during the surgery which is done to remove scar tissue and other calcium deposits to clear the valve passageway,
  • mitral valve replacement that is removing the narrowed valve and replacing it with a tissue or mechanical valve which is made from metal and is durable but a risk in blood clots. You need to take an anticoagulant medication like warfarin or Coumadin to prevent blood clots if you receive mechanical mitral valve. Tissue valves that need to be replaced can come from a cow, pig or human deceased donor. Discuss with your doctor the rick and complications of theses treatments.

6 Prevention

Preventing Rheumatic fever is the best way to prevent the mitral valve stenosis.

Always visit your doctor for checkups especially if you or your family often has sore throats, untreated strep throat infections can also lead to Rheumatic fever but strep throat can be treated by antibiotics.

Ask your doctor first before taking any medications especially antibiotics.

7 Alternative and Homeopathic Remedies

The homeopathic remedies for mitral valve stenosis are:

  • Apocynum vannabium,
  • cactus grandiflorus,
  • crategus oxyacantha,
  • laurocerasus,
  • strophanthus hispidus.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with mitral valve stenosis.

Your doctor may recommend the following:

  • Take care of your teeth, always brush your teeth regularly and use floss;
  • Limit salt, do not use too much salt in your food and avoid high sodium foods for this may increase pressure on your heart, when you are in a grocery read the food labels to see if there are lots of salt in the food;
  • Exercise regularly but not rough exercise or activities but mostly have a cardiovascular exercises, how hard and long you are able to exercise may depend on how severe is your condition and its intensity;
  • See your dentist and doctor regularly;
  • Avoid drinks with too much caffeine because it can worsen arrhythmias or irregular heartbeats;
  • Maintain your health;
  • Cut back on alcohol because it can also cause arrhythmias;
  • Ask your doctor first before thinking of pregnancy because it can cause the heart to work harder, your cardiologist and obstetrician will monitor you all throughout your pregnancy and after your delivery.

If you notice palpitations, go to your doctor immediately.

9 Risks and Complications

There are several risks and complications associated with mitral valve stenosis.

Mitral valve stenosis can strain your heart and decrease blood flow.

Some of the risk factors of mitral valve stenosis includes:

  • history of rheumatic fever which is rare in the United States,
  • heart valve problems,
  • untreated strep infections.

Some of the complications are:

  • heat failure, this occurs when the pressure is build up in your lungs that can lead to fluid accumulation and the heart’s ability to pump blood may be reduced,
  • pulmonary hypertension that occurs when increased pressure in the arteries carries blood from your heart to lungs or pulmonary arteries that may cause you heart to work harder,
  • atrial fibrillation when the upper chambers of your heart beat too quickly,
  • heart enlargement when the pressure build up of mitral valve stenosis results in enlargement of your atrium,
  • untreated atrial fibrillation that can cause blood clots to form in the upper chamber of your heart which can break loose and go in your other body parts causing stroke if it’s in your brain,
  • blood clots,
  • lung congestion or pulmonary edema occurs when your lungs have blood an fluid that can lead to out of breathe or coughing with blood.
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