Mitral Stenosis

WHAT YOU SHOULD KNOW:

• Mitral stenosis is a disease that leads to narrowing of the mitral valve in your heart. Your heart has four chambers (spaces), including two upper atria and two lower ventricles. Your mitral valve is the door between the left atrium and left ventricle. Your mitral valve opens and closes to direct blood flow through the left side of your heart. Mitral stenosis happens when the valve leaflets (flaps) get thicker and stiffer. The valve opening becomes smaller, making it harder for blood to move into the left ventricle. Blood flow through your heart may be decreased, and your heart may not pump enough blood to your body.
  
  
• Mitral stenosis may occur from a condition called rheumatic fever. Stenosis can also be caused by calcium build-up on the mitral valve leaflets. Some people with mitral stenosis were born with a damaged mitral valve. Symptoms may only appear when the stenosis becomes severe (very bad). You may feel tired or short of breath when doing your normal activities. You may feel like your heart is fluttering or jumping in your chest. Tests, such as an EKG, chest x-ray, or echocardiogram may be done to diagnose your mitral stenosis. Treatment includes medicines to decrease your symptoms, and surgery to repair (fix) the stenosis. Having your mitral stenosis treated may improve your ability to be active without tiring so easily. Your symptoms, such as shortness of breath may go away.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• During surgery, the tissues, other heart valves, and nearby areas may get damaged. You may bleed more than expected. After surgery, you may get an infection. The sac that surrounds your heart and its large blood vessels may swell. The swelling may cause fluid to collect around your heart, making it hard for your heart to beat. The valves may stop working well and blood may flow back into the upper chamber of your heart.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot may break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening. Even after treatment, your mitral valve may narrow again.
  
  
• Without treatment, your symptoms, such as shortness of breath and fatigue may get worse. Blood and fluid may build up in your lungs, and your heart may begin to fail. You may get an infection in your heart. Mitral stenosis may cause abnormal heartbeats, which increase the risk of blood clots forming in your heart. You may have a stroke, and you may die. If you are a pregnant woman, mitral stenosis may cause health problems for you and your unborn baby. Your symptoms may get worse, and you and your unborn baby may die. Talk with your caregiver if you have questions or concerns about your condition or treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may be given the following medicines:

• Aspirin: This medicine may be given to help thin the blood to keep blood clots from forming. This medicine makes it more likely for you to bleed or bruise.
  
  
• Blood thinners: This medicine helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
  
  
• Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.
  
  
• Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
  
  
• Steroids: Steroid medicine may help to open your air passages so you can breathe easier.

Tests:

You may need any of the following tests to help caregivers plan, and monitor your treatment:

• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Chest x-ray: A chest x-ray is a picture of your heart and lungs. Caregivers use the x-ray to check the size of your heart. A chest x-ray is also done to look for fluid around your heart and lungs.
  
  
• Echocardiogram: This test is a type of ultrasound. Sound waves are used to show the structure, movement, and blood vessels of your heart.
  
  
• Transesophageal echocardiogram: A transesophageal echo (TEE) may be done if your heart cannot be seen well during a regular echo. You may need a TEE to check for blood clots or a heart infection. You will be given medicine to relax you during a TEE. Caregivers will put a tube in your mouth that is moved down into your esophagus (food pipe). The tube has a small ultrasound sensor on the end. Since your esophagus is right next to your heart, your caregiver can see your heart clearly.
  
  
• Cardiac catheterization: A cardiac catheterization is done to check how well your heart is working, and to look for blockages. A tube is guided into your heart through a blood vessel in your leg or arm. Dye may be given before pictures are taken of your heart. The dye will help your caregivers see the pictures better.

Treatment options:

You may need any of the following:

• Mitral balloon valvotomy: This is surgery to help widen your mitral valve, and allow blood to flow through easier. A catheter (long thin tube) with a balloon on the tip is inserted through a small skin incision (cut). The catheter is guided through a blood vessel and into your left atrium, near your mitral valve. When the balloon is inflated (made larger), it forces the valve to open.
  
  
• Mitral valve commissurotomy: This is surgery to repair and widen the mitral valve in your heart. During surgery, the valve leaflets are separated and calcium build-up may be removed. Surgery helps to improve blood flow to the left ventricle. Caregivers may be able to do this surgery through a small cut in your chest.
  
  
• Mitral valve replacement: This is surgery to replace your damaged mitral valve. During surgery, part, or all of your mitral valve is removed and a new valve is secured in place. The new valve may be from a donor (another person or animal), or may be a man-made valve.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Mitral Stenosis (Inpatient Care)