The most common reasons that the mitral valve becomes thickened, calcified and narrowed are rheumatic valve disease in patients who had rheumatic fever as a child; radiation damage in patients who have had prior chest radiation therapy for various cancers; and degenerative build-up of calcium around the valve (also called mitral annular calcification).
Symptoms of Mitral Stenosis
When patients develop significant narrowing of the mitral valve, pressure builds in the left upper chamber of the heart and in the blood vessels of the lungs. This leads to predictable symptoms including:
- Shortness of breath at rest and with activity
- Heart rhythm difficulties, especially atrial fibrillation
- Increased risk for strokes
Testing for Mitral Stenosis
Mild or moderate mitral stenosis does not need specific intervention or therapy. The one exception is in patients who have atrial fibrillation; these patients are at elevated risk for stroke and need to be on warfarin for anticoagulation.
Severe mitral stenosis can sometimes be heard with a stethoscope due to a characteristic murmur, a noise that the blood makes when it passes through the narrowed or stenotic valve.
More often, echocardiography, or cardiac ultrasound, is used to determine the cause of the stenosis as well as the severity.
Treatments for Mitral Stenosis
Therapy for severe mitral stenosis depends on the reason the valve became narrowed. Patients with rheumatic valve disease can often be treated with balloon mitral valvuloplasty (BMV), a minimally invasive procedure in which a small balloon is inflated on the inside of the mitral valve to stretch it out and allow it to open better. This procedure is done under general anesthesia, through a small incision in the groin.
If patients have significant symptoms and cannot be treated with balloon mitral valvuloplasty, they should be considered for mitral valve replacement.