Mitral valve stenosis can be effectively treated using modern surgical and catheter techniques to re-open the valve and restore normal blood flow.
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Mitral valve stenosis happens when the opening between the two left chambers of the heart becomes too narrow. This slows down the blood flow through the heart. In the early or mild stages, you may not have symptoms (asymptomatic). If you are diagnosed with mitral stenosis, it's important to be monitored by a specialist and eventually get treatment. Depending on the severity of your case, your doctor may treat your symptoms with medication or recommend surgery to repair or replace the valve.
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Diagnosing mitral stenosis
If you have symptoms of mitral valve stenosis, you should speak with a doctor as soon as possible. Mild cases of the condition are usually asymptomatic, so having symptoms is a sign that the disease has already progressed.
To diagnose mitral stenosis, your doctor will perform a physical examination and ask about your medical history and the symptoms you're experiencing. They'll listen to your heart to check for a heart murmur, one of the earliest detectable signs of mitral stenosis. If they think there might be a valve problem, they'll order other tests to confirm a mitral valve stenosis diagnosis.
Tests for mitral stenosis
Diagnosing mitral stenosis requires imaging tests. The main test is an echocardiogram, which is like the ultrasound used to see babies before they're born. It shows how your heart is beating and how blood is flowing through it. Usually, this test is done by placing the ultrasound wand on your chest. This is called a transthoracic echo (TTE). Sometimes, doctors need a closer look and will do an ultrasound through your throat while you're sedated. This is called a transesophageal echo (TEE).
Other common diagnostic tests for mitral stenosis include:
- Chest X-ray: An X-ray of the chest can show the heart and lungs and help the doctor determine if the heart is too large.
- CT scan: A CT scan uses several X-ray images to produce a 3D view of the heart. It can show the heart in detail, including the mitral valve. It also can also check coronary anatomy in preparation for surgery.
- Electrocardiogram (ECG or EKG): This test uses electrodes to measure the heart's activity.
- Cardiac catheterization: This procedure involves inserting a thin tube (catheter) into the blood vessels. It can be used to check for coronary disease by delivering dyes to the coronary vessels or to measure pressure inside the heart chambers if needed.
- MRI: An MRI uses magnetic fields to create highly detailed images of the inside of the body. It can help doctors diagnose and determine the severity of mitral valve stenosis. It’s only used in certain cases when needed.
Stages of mitral valve stenosis
When your doctor diagnoses mitral stenosis, they will grade it based on how severe it is. There are four stages:
- Stage A (at risk): You have risk factors for mitral stenosis but the blood flow through your heart is still normal.
- Stage B (progressive): You have mild mitral stenosis. The valve is slightly narrowed, causing a small effect on blood flow, but there are no noticeable symptoms.
- Stage C (severe asymptomatic): The valve is more significantly narrowed, but you still don’t have symptoms.
- Stage D (severe symptomatic): In the most severe stage, the valve is very narrow, and you experience noticeable symptoms.
Your doctor will recommend the appropriate treatment for mitral stenosis based on the severity of your condition, your medical history, and other factors.
Mitral valve stenosis treatment
Mitral valve stenosis can't be fixed with medication. However, if your condition is mild, your doctor may treat the symptoms with medication and monitor your progress. They can use medication to help you maintain healthy blood pressure, manage heart rate, reduce swelling, and prevent blood clots, strokes, and other dangerous complications.
If your case is more severe, your doctor may recommend surgery or a catheter procedure to treat mitral valve stenosis.
Catheter treatment for mitral valve stenosis
In some cases, your doctor may do a procedure called percutaneous balloon valvuloplasty. A thin tube (catheter) is inserted into an artery and guided to your heart. At the end of the tube is a small balloon, which is inflated to widen the narrowed valve.
Surgical treatments for mitral stenosis
There are two surgical options for treating mitral valve stenosis:
- Mitral valve replacement: Most mitral stenosis cases require a valve replacement. The new valve can be either synthetic (made of metal and carbon) or biological (made from animal tissue).
- Mitral valve repair: When possible, doctors can repair the valve by peeling back the leaflets and widening the valve opening. However, this is only done in select cases.
FAQs about mitral valve stenosis treatment
The prognosis for mitral stenosis depends on when it’s diagnosed, your age, overall health, and other factors. The earlier mitral stenosis is diagnosed, the better your outcome will be, especially for younger, healthier patients.
Limit salt, sugar, and fat to help keep your blood pressure healthy. Otherwise, follow a balanced diet during treatment for mitral stenosis. While changing your diet won’t cure or reverse mitral valve stenosis, it can help manage your symptoms.
Most commonly, mitral valve disorders involve a leaky valve due to mitral valve prolapse. This causes blood to flow backward (mitral valve regurgitation), or a narrowed valve that blocks blood flow (mitral valve stenosis). Other causes, like congenital malformations or endocarditis, are very rare.
The first line of treatment for severe mitral stenosis is a catheter procedure called balloon valvuloplasty (also known as percutaneous balloon mitral commissurotomy). In this procedure, your doctor inserts a thin tube (catheter) into a blood vessel and guides it to your heart. A small balloon at the end of the catheter is then inflated to re-open the valve.
