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Mitral Stenosis


What is mitral stenosis?

Mitral stenosis is a condition that makes your mitral valve narrow and stiff. The mitral valve is between the left atrium and the left ventricle of your heart. The valve opens and closes to direct blood flow through your heart. With mitral stenosis, your valve may not open or close properly. This causes strain on your heart muscle and decreases blood flow to your body.

Normal mitral valve Narrow mitral valve

What causes mitral stenosis?

  • Rheumatic fever can develop after you have a strep throat infection. Rheumatic fever can cause inflammation and damage to your mitral valve. The walls of your mitral valve may narrow, and may even join together.
  • Calcium buildup can happen as you age. Calcium can build up on the mitral valve walls and make them narrow and stiff.
  • Congenital heart defect means you are born with a damaged mitral valve that leads to narrowing and blockage.

What are the signs and symptoms of mitral stenosis?

You may not have any symptoms, if your mitral stenosis is mild. You may have any of the following:

  • Shortness of breath during activity or when you lie down
  • Severe tiredness
  • Swollen feet or ankles
  • Fast, jumpy, or fluttery heartbeat
  • Coughing up bloody tinged mucus
  • Dizziness or fainting
  • Headache and stroke symptoms

How is mitral stenosis diagnosed?

Your healthcare provider will ask about your signs and symptoms and listen to your heart. He or she will ask if you have ever had strep throat or rheumatic fever. You may need any of the following tests:

  • Blood tests: You may need blood taken to give healthcare providers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  • A chest x-ray shows the size of your heart. It may also show if fluid is around your heart and lungs.
  • An EKG test records the electrical activity of your heart. It is used to check for abnormal heart rhythm caused by aortic stenosis.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.
  • A stress test may show the changes that take place in your heart while it is under stress. Stress may be placed on your heart with exercise or medicine. Ask for more information about this test.
  • Cardiac catheterization is a procedure done to find and treat heart blockages. A catheter (long thin tube) is inserted into your arm, neck, or groin and moved into your heart. An x-ray may be used to guide the tube to the right place. Contrast liquid may be put into your vein so the pictures show up better on a monitor. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is mitral stenosis treated?

Treatment for mitral stenosis depends on how severe your symptoms are. If you do not have symptoms, your healthcare provider will do tests regularly. You may need medicines to treat your symptoms of extra fluid, arrhythmias (irregular heartbeats), and blood clots. You may also need any of the following if your symptoms become worse:

  • Balloon valvuloplasty helps widen your mitral valve and allow blood to flow through easier. It is also called a closed valvotomy. A catheter with a balloon on the tip is inserted through a small incision in your arm or groin. The catheter is guided through a blood vessel and into your left atrium near your mitral valve. When the balloon is inflated, it stretches the valve opening.
  • Commissurotomy is open heart surgery to fix your mitral valve. It is done if valvuloplasty does not correct your mitral stenosis. During a commissurotomy, your surgeon will remove calcium buildup and scar tissue from your valve.
  • Valve replacement is a surgery to remove part or all of your mitral valve. A new valve is then secured in place. The new valve may be from a donor (another person or animal), or may be an artificial valve. There are 2 different approaches for valve replacement. The first is an open heart procedure. The second is a procedure that replaces the valve through a catheter guided into a vessel in your groin. Your healthcare provider will talk to you about which approach is right for you.

How can I manage my symptoms?

  • Eat heart healthy foods. Eat whole grains, fruits, and vegetables every day. Limit salt and high-fat foods. Ask your healthcare provider for more information on a heart healthy diet.
  • Take care of your teeth and gums. Gingivitis, a gum disease, increases your risk for aortic stenosis. See your dental provider regularly to treat problems early.
  • Exercise as directed. Exercise will improve your heart health. Ask your healthcare provider about the best exercise plan for you. Start slowly and increase activity as you get stronger. Stop if you feel short of breath.
  • Limit caffeine. Caffeine can make irregular heartbeats worse. Ask your healthcare provider about eating or drinking anything that contains caffeine. Ask him or her how much caffeine is safe for you.
  • Limit alcohol. Ask your cardiologist if it is safe for you to drink alcohol. Alcohol can increase your symptoms.
  • Talk to your healthcare provider about pregnancy. If you are a woman and want to get pregnant, talk to your healthcare provider. You and your baby may need to be monitored by specialists during your pregnancy.

Call 911 or have someone else call if:

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

When should I seek immediate care?

  • Your symptoms get worse.

When should I contact my healthcare provider?

  • The veins in your neck look swollen or are bulging.
  • You have a fever.
  • You have questions or concerns about your condition or care.

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 healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. 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.

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Further information

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