From the Guidelines
Mitral valve stenosis typically presents with symptoms such as shortness of breath, fatigue, and heart palpitations due to the narrowing of the mitral valve, which restricts blood flow from the left atrium to the left ventricle 1.
Common Symptoms
- Shortness of breath (dyspnea), especially during physical activity or when lying flat (orthopnea)
- Fatigue
- Heart palpitations
- Chest discomfort
Advanced Symptoms
- Hemoptysis (coughing up blood)
- Hoarseness due to compression of the recurrent laryngeal nerve by an enlarged left atrium
- Signs of right heart failure such as peripheral edema and ascites
- Atrial fibrillation, which can cause irregular heartbeats and increase the risk of blood clots and stroke
Disease Progression
The restricted blood flow through the stenotic valve causes increased pressure in the left atrium, which backs up into the lungs, causing pulmonary congestion and the characteristic breathing difficulties. Early symptoms may only appear during exertion when the heart needs to pump more blood, while advanced stenosis can cause symptoms even at rest.
Importance of Medical Evaluation
If you experience these symptoms, especially progressive shortness of breath, immediate medical evaluation is essential for proper diagnosis and treatment, as indicated by the 2017 ESC/EACTS guidelines for the management of valvular heart disease 1.
From the Research
Symptoms of Mitral Valve Stenosis
The symptoms of mitral valve stenosis can vary depending on the severity of the condition. Some common symptoms include:
- Shortness of breath or difficulty breathing, especially during physical activity or when lying down
- Fatigue or weakness
- Palpitations or irregular heartbeat
- Coughing or wheezing
- Swelling in the legs or feet
Causes and Risk Factors
Mitral valve stenosis is often caused by rheumatic heart disease, which is a complication of rheumatic fever 2. Other risk factors include:
- Age: Mitral valve stenosis is more common in older adults
- Sex: Women are more likely to develop mitral valve stenosis than men
- History of heart disease: People with a history of heart disease are more likely to develop mitral valve stenosis
Treatment Options
Treatment for mitral valve stenosis depends on the severity of the condition. Some treatment options include:
- Medications: Such as diuretics, beta blockers, and anticoagulants to control symptoms and prevent complications 3
- Percutaneous balloon mitral valvuloplasty: A minimally invasive procedure to widen the mitral valve 2
- Surgery: To repair or replace the mitral valve
Management of Atrial Fibrillation
Atrial fibrillation is a common complication of mitral valve stenosis. Management of atrial fibrillation includes: