Mitral Stenosis

Mitral stenosis — also called mitral valve stenosis — is a heart condition where the valve controlling the flow of blood from the upper chamber to the lower chamber on the left side of your heart is blocked.

When your blood can't flow easily, it backs up into the upper chamber of your heart, then into your lungs. This causes serious issues, including one or more of the following:

• Blood clots, which can cause a stroke or other problems
• Pulmonary edema (fluid in a lung)
• Pulmonary hypertension (high blood pressure in the arteries of your lungs)
• Congestive heart failure
• Arrhythmia (irregular heartbeat)

Causes of Mitral Stenosis

Mitral stenosis may be caused by the following:

• Rheumatic fever, which results from an untreated strep infection. In the United States, rheumatic fever is rare because people typically receive proper treatment for strep infections.
• Calcium deposits, which build up around the mitral valve as you age.
• Chest radiation or certain autoimmune disorders, in rare cases.

Mitral stenosis can also be congenital (something you are born with) and is usually present with other heart defects.

Mitral Stenosis Symptoms

Though people of all ages may experience symptoms of mitral stenosis, most people begin noticing symptoms between the ages of 20 and 50.

You may have been diagnosed with mitral stenosis many years ago, and you may not have experienced any symptoms. Then, symptoms may come on suddenly. Symptoms can also emerge when the body is stressed, such as during pregnancy or when you have an infection.

Symptoms of mitral stenosis include the following:

• Shortness of breath (dyspnea), especially during or after exercise or while lying down
• Waking up at night coughing or having trouble breathing
• Heart palpitations (irregular, pounding or skipped heartbeats)
• Fatigue
• Coughing, possibly with blood in the mucous that is coughed up
• Swollen ankles or feet
• Chest pain or discomfort

Call your primary care doctor as soon as possible if you are experiencing any of the symptoms of mitral stenosis. After examining you, your primary care doctor may send you to a cardiologist for further evaluation and treatment.

If you are experiencing severe shortness of breath or chest pain, seek immediate medical care by calling 9-1-1 or going to an emergency room for evaluation.

Mitral Stenosis Diagnosis

To get a close look at the structure of your heart and how it is functioning, you may need one or more of the following diagnostic tests:

• Echocardiogram: Using sound waves, this noninvasive test shows the structure of your heart and how it is functioning.
• Transesophageal echocardiogram: This test involves inserting a tube down your esophagus to get a closer look at your heart using sound waves.
• Electrocardiogram (ECG): This test measures the electrical activity of your heart, including arrhythmias (irregular heartbeats).
• Imaging: You may have a chest X-ray, MRI and/or CT scan to get a more precise view of your heart and lungs.

Treatment for Mitral Stenosis at RUSH

Treatment depends on how severe your stenosis is, your overall condition and whether you have other heart problems. Your treatment team may recommend one or more of the following:

• Watchful waiting: If you have mild to moderate stenosis, you may not need treatment at this time, and your cardiologist will continue to monitor your condition.
• Medication: If you have other heart defects in addition to mitral stenosis, your cardiologist may prescribe medication to help your heart function better. If your mitral stenosis was caused by rheumatic fever, you may need to take antibiotics throughout your life to prevent infections.
• Valvuloplasty: If you don't have any other heart deformities, your cardiologist may perform valvuloplasty (balloon dilation) to stretch the narrow opening and allow more blood to flow through. Your cardiologist guides a catheter (a thin, flexible tube) to your mitral valve, then inflates a balloon at the tip of the catheter.
• Surgery: If valvuloplasty is not an option, your heart surgeon may perform open-heart surgery to remove any calcium deposits or scar tissue around your mitral valve. If your mitral valve is no longer able to function, your heart surgeon can replace it with a biological or synthetic valve. Sometimes, this procedure can be done using minimally invasive techniques. Your surgeon will talk to you about which approach is right for you.

RUSH Excellence in Mitral Stenosis

• All the experts in one place: You'll meet with a team of specialists — including an interventional cardiologist and a cardiac surgeon — at one time to ensure coordinated, comprehensive care. Your team then creates a personalized treatment plan for you during that same visit.
• Expert care: Cardiologists at RUSH have been leaders in bringing innovative nonsurgical approaches to patients. And cardiac surgeons are highly skilled at both open heart valve surgery and minimally invasive valve replacement.
• Collaboration and convenience: Some of the procedures used to treat mitral valve stenosis take place in RUSH University Medical Center's interventional platform, where procedures are centralized to allow specialists to collaborate more easily and ensure convenience for patients and families.
• Among the best in the nation: RUSH University Medical Center is ranked among the best in the nation for cardiology and heart surgery by U.S. News & World Report.