Causative & risk factors
Rheumatic fever is the single largest cause of stenosis of the mitral valve. Mitral valve stenosis can also be congenital. Elderly people may develop deposition of calcium on the valve leading to stenosis.
Clinical presentation
Persons with mitral valve stenosis may not develop any symptoms for 1 or more decades (10 to 40 years). The first symptom to appear is usually loss of breath with mild exertion. As the disease progresses, the patient may start experiencing breathlessness even at rest. The patient starts experiencing weakness and palpitations. He may have episodes of faintness, dizziness or chest pains. Infections of the chest occur frequently in such patients.
Investigations
Physical examination of the patient usually reveals the presence of heart murmurs (abnormal sounds).
Several tests will be performed to assess the severity of stenosis including an ECG, echocardiogram and a chest X-ray.
Treatment
Patients with mild stenosis only need to be observed and followed up regularly by the physician.
Medications such as diuretics, anticoagulants, ACE inhibitors and certain heart medicines are prescribed according to the patient’s symptoms.
Severe cases of mitral valve stenosis are usually treated surgically. The procedure used may be balloon valvotomy, commisurotomy or mitral valve replacement surgery.
