Mitral Valve Stenosis

Mitral valve stenosis, or mitral stenosis, is a narrowing of your heart's mitral valve — a one-way valve that opens and closes to control the flow of blood through your heart.

UPMC is a leader in diagnosing and treating mitral valve stenosis and researching the latest treatments.

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On this page

• What Is Mitral Valve Stenosis?
• What Are the Symptoms of Mitral Valve Stenosis?
• How Do You Diagnose Mitral Valve Stenosis?
• How Do You Treat Mitral Valve Stenosis?

What Is Mitral Valve Stenosis?

The mitral valve is located between the heart's left upper chamber (the left atrium) and the heart's lower left chamber (the left ventricle). It opens to allow blood to move out of the atrium and into the ventricle. It then closes to prevent blood from moving in the wrong direction.

When a heart with a healthy mitral valve squeezes, it sends blood from the atrium to the empty left ventricle.

The mitral valve's two flaps — or leaflets — open to allow blood to pass through. When the heart relaxes and the ventricle fills with blood, the flaps close.

Mitral valve stenosis prevents your mitral valve from opening properly, in some cases by causing the two flaps to partially fuse together. This prevents some of the blood from moving out of the atrium.

How common is mitral valve stenosis?

Mitral valve stenosis is an uncommon condition. Estimates show it affects only 1 in 100,000 people in the U.S.

What causes mitral valve stenosis?

Calcium may build up around your mitral valve as you age, causing mitral valve stenosis.

Mitral valve stenosis can also result from rheumatic fever, a childhood illness that occurs alongside conditions like strep throat or scarlet fever. Complications from these illnesses can damage the mitral valve or even cause it to fuse, though symptoms may not appear until years later. Although extremely rare in the United States due to effective antibiotics, rheumatic fever is still the second leading cause of mitral valve stenosis.

Other causes of mitral stenosis include:

• Some rare medications.
• Prior external radiation to the chest cavity during cancer treatment.
• Prior known history of congenital, or birth-related, abnormalities.

What are mitral valve stenosis risk factors and complications?

Mitral valve stenosis risk factors

Risk factors for mitral valve stenosis include:

• Age.
• Congenital heart conditions.
• History of rheumatic or scarlet fever.
• History of heart attack.
• Radiation to the chest to treat cancer.

Complications of mitral valve stenosis

Without treatment, mitral valve stenosis can lead to:

• Atrial fibrillation (AFib) – A common type of abnormal heart rhythm.
• Blood clots – Atrial fibrillation increases the risk of developing blood clots.
• Heart failure – A condition in which your heart cannot pump enough blood to meet your body's needs.
• Heart enlargement.
• Fluid build-up in the lungs.

How can I prevent mitral valve stenosis?

You may not be able to control some of your risk factors for mitral valve stenosis, such as aging and congenital conditions. However, eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, quitting smoking, limiting alcohol, avoiding recreational drugs, and controlling chronic conditions such as high blood pressure and high cholesterol may help to lower your risk.

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What Are the Signs and Symptoms of Mitral Valve Stenosis?

Many people with mitral valve stenosis have no symptoms at all. When symptoms do occur, they usually begin gradually in people in their 30s or 40s, though they can occur at any age.

Symptoms of mitral valve stenosis can appear suddenly and worsen when your heart rate rises during exercise or physical exertion. Pregnancy and infection can also bring on symptoms. Telltale signs include heart murmur and irregular heart rhythms, or arrhythmias.

Some people with the condition may have mild symptoms that worsen over time, including:

• Coughing, sometimes with blood.
• Fatigue, especially when exercising.
• Frequent lung infections, such as bronchitis.
• Heart palpitations, which is the sensation of feeling your own heartbeat.
• Shortness of breath during mild exertion, at rest, or when you lie down.
• Swollen feet or ankles (edema).

When should I see a doctor about my mitral valve stenosis symptoms?

You should call a doctor if you have:

• A fluttering, pounding, or fast heartbeat when at rest.
• New swelling of the legs, feet, or ankles.
• Trouble breathing when exercising, with exertion, or at rest.

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How Do You Diagnose Mitral Valve Stenosis?

Your doctor will ask about your medical history and do a physical exam.

What are the physical findings of severe mitral stenosis?

Mitral valve stenosis often causes murmurs or strange sounds of blood flowing through your heart.

What to expect during your visit

During your physical exam, your doctor will:

• Ask about your symptoms and when they started.
• Discuss your medical history.
• Listen to your heart with a stethoscope.

Your doctor may order further tests if they hear a heart murmur or if you are having symptoms.

Tests to diagnose mitral valve stenosis

Tests your doctor may use to diagnose mitral valve stenosis include:

• Chest x-ray – Lets your doctor see the size and shape of your heart.
• Echocardiogram (ECHO) – A heart ultrasound that uses sound waves to make images of the structures of your heart. This is often the first step.
• Electrocardiogram (EKG) – Measures the electrical activity of your heart.
• Heart catheterization– An outpatient test that lets the doctor see blood flow through your heart and its arteries.
• MRI scan – Uses a magnet and radio waves to take pictures of your mitral valve.
• Transesophageal echocardiogram (TEE) – An outpatient test using sound waves like a standard ECHO within your esophagus. TEE gives doctors precise images of your heart valve, often in 3D. This is one of the best ways to diagnose mitral stenosis correctly.

Mitral valve stenosis prognosis

Early diagnosis and treatment of mitral valve stenosis can improve your long-term outcomes and survival rate. Your doctor will discuss your prognosis with you.

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How Do You Treat Mitral Valve Stenosis?

At UPMC, we take a team approach to diagnosing and treating mitral valve stenosis. The initial goal is to reduce symptoms of heart failure using medication.

In addition, your UPMC doctor may recommend repairing or replacing the valve, either minimally invasively or surgically. Your doctor will use the approach that best meets your needs, which may include:

Balloon valvuloplasty for mitral valve stenosis

Balloon valvuloplasty is a minimally invasive procedure in which an interventional cardiologist inserts a catheter into a small blood vessel through a tiny incision in your groin.

The cardiologist guides the catheter through your blood vessels to the mitral valve. The catheter has a small balloon at its tip, which the interventional cardiologist inflates and deflates.

Inflating the balloon forces the fused portion of the leaflets to separate. This helps the valve to open more fully and allow more blood to pass through with each heartbeat.

Minimally invasive mitral valve repair

If you have severe mitral stenosis and balloon valvuloplasty is not possible, your doctor may recommend minimally invasive catheter-based surgery to repair your valve. Your surgeon will evaluate your valve and determine if it can be surgically repaired.

Surgical mitral valve replacement

Your surgeon may recommend valve replacement surgery if your mitral valves cannot be repaired.

After your surgeon has removed your mitral valve, he or she will replace it with a mechanical or tissue valve.

• Mechanical valves last a long time, but they can cause blood clots. People with mechanical valves must take blood-thinning medication to prevent blood clots.
• Tissue valves do not cause clots, but they do not last as long as mechanical valves and will eventually need to be replaced after 10 or more years.

H3: How effective is treatment?

At UPMC, our team performs mitral valve repair procedures every day with a repair success rate of more than 90 percent. Our mitral valve replacement procedures have similar outcomes, with most otherwise healthy patients returning to a normal, active lifestyle after surgery.

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Why Choose UPMC for Mitral Valve Stenosis Care?

At UPMC, our multidisciplinary team of cardiac surgeons, interventional cardiologists, cardiologists, anesthesiologists, and nurses works together to:

• Help our patients enjoy an improved quality of life.
• Participate in mitral valve research, allowing us to offer the latest treatments and techniques for mitral valve stenosis.
• Provide custom treatment plans for each mitral valve stenosis patient.

By UPMC Editorial Staff. Last reviewed on 2024-10-01.