From the Guidelines
The main risk factor for developing mitral stenosis is a history of rheumatic fever, which accounts for most cases worldwide, as stated in the most recent study 1. Rheumatic fever, an inflammatory reaction to group A streptococcal infection (typically strep throat), can damage heart valves, particularly the mitral valve. The valve damage progresses slowly over years or decades, causing gradual narrowing. Other risk factors include:
- Congenital heart defects present at birth
- Calcium deposits forming around the mitral valve ring (particularly in elderly patients)
- Radiation therapy to the chest
- Certain medications like ergotamine derivatives and some diet drugs
- Rare conditions such as carcinoid syndrome or systemic lupus erythematosus Mitral stenosis is more common in women than men, and in developing countries where rheumatic fever remains prevalent due to limited access to antibiotics for treating strep infections, as noted in 1. Prevention focuses on prompt treatment of strep throat with appropriate antibiotics like penicillin to prevent rheumatic fever development, as recommended in 1. For those with a history of rheumatic fever, long-term antibiotic prophylaxis may be recommended to prevent recurrence and further valve damage, as suggested in 1. It is essential to consider the most recent and highest quality study, which is 1, when making a definitive recommendation regarding the risk factors for developing mitral stenosis.
From the Research
Risk Factors for Mitral Stenosis
The development of mitral stenosis is primarily associated with the following risk factors:
- Acute rheumatic fever (RF), which is a sequela of group A β-hemolytic streptococcal infection 2, 3
- Rheumatic heart disease (RHD), which is more prevalent in non-industrialized countries and can be introduced to Western countries through immigration 2
- Geographic and ethnic factors, such as being of Bedouin descent, which may increase the risk of progressive disease 4
Demographic and Clinical Factors
Additional factors that may influence the development and progression of mitral stenosis include:
- Age, with adults over 30 years old being included in studies on the natural history of rheumatic mitral stenosis 4
- Medical history, including the presence of other valve diseases, heart failure, and pericarditis 3
- Echocardiographic reports, which can help assess the severity of mitral stenosis and predict progression 4
Complications and Progression
Mitral stenosis can lead to various complications, including: