Mitral Valve Stenosis

The mitral valve lies between the left atrium and left ventricle. The valve has two flaps or 'cusps'. The valve allows blood to flow into the left ventricle when the left atrium contracts. When the left ventricle contracts, the valve closes and the blood flows out through the aortic valve into the aorta.

Mitral stenosis (mitral valve stenosis) is the narrowing of the mitral valve opening that increases resistance to blood flow from the left atrium(upper chamber of the heart) to the left ventricle(lower chamber of the heart). Patients with mitral stenosis typically have mitral valve leaflets that are thickened, commissures that are fused, and/or chordae tendineae that are thickened and shortened. This prevents proper blood flow from moving between the left atrium and ventricle.

Mitral stenosis usually results from rheumatic fever, but infants can be born with the condition(Congenital heart defect). Babies born with this problem usually require heart surgery to correct the valve. Others are born with a malformed mitral valve that puts them at risk of developing mitral stenosis when they're older. Although the attack rate for rheumatic fever is roughly equal among genders, mitral stenosis is 2-3 times more common in women than in men.

Signs and symptoms often appear between the ages of 20 and 50, but they can occur at any age — even during infancy. Signs and symptoms of mitral valve stenosis depend on how severely and quickly the condition develops. Some people never develop symptoms. However, mild problems can suddenly get worse. Symptoms include:

• abnormal breathlessness
• frequent attacks of bronchitis
• spitting of blood often occurs
• heart murmur
• lung congestion
  
• chest pain on exertion

Symptoms may begin with an episode of atrial fibrillation or may be triggered by pregnancy or other stress on the body such as infection (in the heart, lungs, etc.) or other cardiac disorders.

Treatment
Mitral valve stenosis is treatable in people of all ages. Treatment depends on the severity and progression of the diseased valve. If the condition is severe enough, heart surgery may be needed to repair or replace the valve. Drug treatment includes the use of diuretics and beta-blockers or calcium channel blockers. Anticoagulants may be needed to prevent clot formation in people with atrial fibrillation. If drug therapy does not reduce the symptoms satisfactorily, the valve may be repaired or replaced -- Mitral Valve Surgery to stretch, repair or replace the valve may be needed. For more details about surgical treatment of valvular disease and Mitral Valve Repair, visit Maryland Heart Center.