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What Is Mitral Stenosis and How Can Doctors Deal With It
What is Mitral stenosis? If stated in simple words, it is nothing but the narrowing down of the mitral valve. This valve is located on the left of the heart, between the left ventricle and left atrium. This valve maintains the flow of blood in one direction from the atrium into the ventricle.
Causes of the narrowing down or stenosis of the mitral valve:
Congenital mitral stenosis - a birth defect where the infant has a narrowed valve
Tumor such as left atrial myxoma - this blocks the valve from opening
Result of the narrowing and its effect on the body:
Here, both the leaflets of the valve (mitral) slowly begin fuse. This makes it difficult for the blood that is traveling to the atrium (left) from the lungs to go through the mitral valve, to the ventricle (left). As the condition progresses in severity, blood goes back to the lungs. This results in the accumulation of blood and fluid in the air sacs, in the lungs (congestion).
Symptoms and signs:
Shortness of breath
Orthopnea in severe cases where it is difficult to lie flat in bed,
Paroxysmal nocturnal dyspnea, causing one to wake up at odd hours with severe shortness of breath and hunger for air.
Hemoptysis or coughing up of blood
Palpitations or Irregular heart beats - also common because of the high incidence of atrial fibrillation
On examination, a doctor will listen to your heart for abnormal sounds and one such sound called a heart murmur will be heard.
The physician may order a few or all of the following diagnostic tests:
Chest x-ray: This provides the doctor with information regarding the size of the heart and the four chambers and also vital information regarding the lungs. Enlargement of the left atrium and congestion of the lungs is the usual findings.
Electrocardiogram (ECG) - This records changes in the electrical activity that occurs during a heartbeat. It aids in the diagnoses of irregularities in the heart rate and rhythm. It also provides information regarding cardiomegaly or any cardiac muscle damage. Atrial fibrillation is one such finding that is seen in mitral stenosis.
Echocardiogram or echo - This test is used to examine the heart using ultrasound. It helps in measuring the structure of the heart. It is an important test to evaluate the area of the valve and also the degree of stenosis. It gives a fair idea about the valvular quality and whether it is calcified heavily or not. This data is very essential to plan further treatment.
Cardiac catheterization/coronary arteriogram: An angiogram is warranted for those who are 40 years of age or above. It is essential to detect if the coronary arteries have serious blocks and if a coronary artery bypass surgery is needed at the same time as the valve surgery.
Always keep in mind that prevention is very crucial as far as this condition is concerned since rheumatic fever is the major culprit for it to occur. So, never neglect a strep throat infection. Prevent rheumatic fever and also damage to the valves of the heart.
Balloon mitral valvotomy (BMV): This is the widening of the mitral valve via cardiac catheterization. This can be an option if the mitral valve is not calcified heavily and there is no associated incompetence of the valve.
Surgery: If the valve is not calcified yet, it could be widened via open heart surgery. If there are heavy calcification and significant damage, the valve can be replaced using a bioprosthetic valve (made from animals like pigs and cows) or a mechanical valve.