Untreated mitral valve stenosis can interfere with your daily life, but it can also lead to complications, including atrial fibrillation, stroke, and heart failure.
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What is mitral valve stenosis?
Mitral valve stenosis occurs when the opening between the two left chambers of the heart is too narrow, becomes blocked, or can't open completely. When that happens, blood can't flow through the heart normally. The reduced blood flow causes a buildup of pressure in the heart and causes backup of blood in the lungs and makes it hard to send blood to the rest of the body's tissues.
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Symptoms of mitral stenosis
The most common symptom of mitral stenosis is shortness of breath, either during exercise or when lying down. Other common symptoms include:
- Fluid in the lungs, causing trouble breathing
- Swelling in the ankles and feet
- Fatigue
- Lack of stamina
- Coughing up blood
- Fainting
- Heart murmur
- Heart palpitations (a feeling of racing or fluttering heartbeat)
- Irregular heartbeat (atrial fibrillation)
Stages of mitral stenosis
Like some other heart valve disorders, such as mitral valve regurgitation, mitral valve stenosis has four stages:
- Stage A (at risk): In Stage A, you show risk factors for mitral stenosis but still have normal blood flow through the heart.
- Stage B (progressive): Stage B indicates mild mitral valve stenosis that does not usually cause noticeable symptoms. Your valve is narrowed and slightly restricts blood flow.
- Stage C (severe asymptomatic): The valve restriction is more extreme. It significantly affects blood flow but doesn't cause any noticeable symptoms.
- Stage D (severe symptomatic): The condition is severe and causes symptoms, especially shortness of breath and difficulty exercising.
It's possible for the mitral valve to narrow slightly but still allow enough blood flow for normal function, so mild mitral stenosis may not have any noticeable symptoms. If you have symptoms of mitral valve stenosis, your condition may have already progressed to more severe stages.
Often, mitral stenosis doesn't cause symptoms until it's in the severe stages. Those symptoms result from your body not getting enough oxygen-rich blood and from your heart working too hard and from your lungs being too congested. If you don't get treatment for mitral stenosis, it can lead to severe complications, including heart failure.
Causes of mitral stenosis
The most common cause of mitral stenosis is a complication of strep throat called rheumatic fever, which can cause scar tissue to form on the leaflets of the mitral valve, causing its narrowing. Fortunately, rheumatic fever is rare in countries with easy access to antibiotics, like the U.S.
Other causes include:
- Wear and tear (degeneration): Calcium deposits can form in the heart as we age, eventually blocking the valve. This kind of mitral stenosis is most common in older people since it takes time for the calcium to build up enough to cause problems.
- Congenital (present at birth) heart defects: Some babies are born with a narrow mitral valve because the heart didn't form correctly during the baby's development. If this kind of defect isn’t identified and treated, the child usually dies in the first few years of life.
Risk factors for mitral valve stenosis
Significant risk factors for mitral stenosis include:
- Age: Older adults are more likely to have mitral stenosis caused by calcium buildup.
- Gender: Mitral stenosis is more common among biological females.
- Untreated infections: Rheumatic fever and other infections can damage the heart if left untreated.
- Radiation: Exposure to chest radiation, such as radiotherapy for cancer, can increase your risk of mitral valve disease.
- Family history: People who have a close relative with mitral stenosis are more likely to develop the condition.
- Untreated mitral valve prolapse that progressed to mitral annular calcification (MAC)
- Illegal drugs: MDMA (ecstasy) increases the risk of mitral valve disorders.
Treating mitral valve stenosis
Medication can't fix your mitral valve, but it can ease symptoms and make the condition less stressful on your heart. Depending on the stage and cause of your mitral valve stenosis, you may need surgery to repair or replace the mitral valve.
FAQs about mitral valve stenosis
The most common cause of mitral stenosis is rheumatic fever, a rare complication of strep throat. It's not common in developed countries with easy access to antibiotics.
The first easily detected symptom of mitral stenosis is usually a heart murmur, an abnormal sound when the heart beats. Your doctor may detect a heart murmur during a routine check-up or during a scheduled examination if you suspect a valve problem.
The first symptoms you are likely to notice without a doctor are the primary symptoms of mitral stenosis: shortness of breath, fatigue, and heart palpitations.
Some prescription medications raise your likelihood of mitral valve disease. Among these are migraine medications that contain ergot alkaloids and older weight loss drugs containing fenfluramine, which is no longer sold in the U.S.
The illegal drug MDMA (ecstasy) can also cause mitral valve disease.
There is no direct link between stress and mitral valve conditions.
Mitral valve stenosis is a form of heart disease called "heart valve disease." It's not the same as coronary heart disease which affects the blood vessels. Heart valve disease can still cause serious symptoms and complications and requires intervention.
