What is mitral stenosis?
Mitral stenosis, or mitral valve stenosis, is a narrowing of the mitral valve. One of your heart’s four valves, the mitral valve controls blood flow between the left atrium (upper chamber) and left ventricle (lower chamber) of the heart. Stenosis can restrict the amount of blood flowing through the heart to the rest of the body.
Your mitral valve normally opens to allow blood to flow, then closes to prevent it from flowing back. When the mitral valve narrows, blood flow is limited. As a result, blood can get trapped in your left atrium, putting pressure on the blood vessels that bring oxygen-rich blood from your lungs to your heart. Over time, this pressure can cause your heart’s upper chambers to get larger and allow fluid to build up in your lungs.
Mitral stenosis symptoms
Mitral stenosis typically does not cause symptoms unless it is severe. You may not know you have it until your doctor hears a heart murmur when listening to your heart at a routine check-up.
However, you might experience symptoms when your heart is under stress, for example, during pregnancy or an infection.
Symptoms of mitral stenosis may include:
- Breathing difficulties during or after activity or when lying down
- Chest pain or discomfort with activity that radiates to the arm, neck, jaw or other parts of the body
- Coughing that may be bloody
- Fainting
- Feeling dizzy or lightheaded
- Feeling very tired
- Flushed cheeks that appear purple (mitral facies)
- Frequent respiratory infections
- Heart palpitations
- Shortness of breath when resting
- Swollen ankles or feet
Mitral stenosis can also exist at birth. In babies and children with the condition, symptoms usually appear by age 2 and may include:
- Coughing
- Problems gaining weight, possibly due to feeding difficulties
- Shortness of breath
- Slowed growth
When to see a doctor
See your doctor if you have symptoms of mitral stenosis, particularly if you have a bloody cough, which could suggest severe narrowing of the valve. Always call 911 if you experience chest pain that radiates to your neck, back or jaw, shortness of breath and dizziness, or lightheadedness, as these could be signs of a heart attack.
Because the condition often causes no symptoms, having regular checkups with your primary care doctor allows them to identify heart murmurs and other signs early.
Causes of mitral stenosis
Mitral stenosis can be caused by a birth defect. The most common cause in adults is rheumatic fever, an infection that can develop after untreated strep throat or other infections. Mitral valve symptoms may not appear until decades after an illness.
Narrowing of the valve can also be caused by a buildup of calcium, which is more common as you get older. Other possible, but less common, causes include:
- Endocarditis, an infection of the heart and heart valves
- Radiation treatments to the chest
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Whipple disease
- Carcinoid, a slow-growing tumor
Mitral stenosis risk factors
Having a condition linked to mitral stenosis can increase your risk. However, it’s becoming less common in the United States thanks to better infection treatments that have lowered rates of rheumatic fever, the leading risk factor for mitral stenosis.
Mitral stenosis becomes more common with age. Older adults are more likely to have calcium buildup on their valves, and they may have had an infection early in life before the widespread use of antibiotics. Mitral stenosis is also common in parts of the world where antibiotic use is lower than it is in the US.
Additional risk factors include:
- Genetics: Mitral stenosis may run in families and can be linked to genetics.
- Sex: Mitral stenosis caused by rheumatic fever is more common in women than men.
Complications
Left untreated, mitral stenosis can lead to serious complications. Reduced blood flow through your valve can mean less oxygen-rich blood is pumped around your body. As blood builds up in your left atrium, this can increase pressure. Blood clots can form, which may break off and travel to other parts of your body.
Possible complications include:
- Arrhythmias: Problems with the mitral valve can cause atrial fibrillation or atrial flutter.
- Heart failure: The added strain on the heart may reduce its ability to pump enough blood for the rest of your body, leading to heart failure.
- Pulmonary edema: As blood builds up in your left atrium, fluid can collect in your lungs. This is called pulmonary edema.
- Pulmonary hypertension: Pressure buildup can cause high blood pressure in the lungs.
- Stroke: A blood clot blocking blood flow to your brain can cause an ischemic stroke .
Diagnosing mitral stenosis
The diagnostic process for mitral stenosis often begins when your doctor hears a heart murmur during a physical exam. Many lifestyle factors and conditions can cause a murmur, so they will likely try to determine its cause.
You may need various tests to determine whether you have mitral stenosis or another condition. Your doctor may refer you to a cardiologist.
-
Medical history and exam
Your doctor will ask about your medical history, your family history and any other health conditions you have. They will listen to your heart with a stethoscope to see if you have a heart murmur. You might be asked to walk around, as exercise can make a murmur louder.
Your doctor will also perform a physical examination, looking for signs such as bulging veins or swelling in your ankles and feet.
-
Imaging and tests
Tests and scans give your doctor a better look at your heart and help them determine what’s causing your symptoms. If you have mitral stenosis, scans can help your doctor with mitral stenosis grading. This means using factors such as the mobility and thickness of your valve to assess how severe your condition is.
Tests and scans may include:
- Chest X-ray: X-ray images allow your doctor to see your heart and lungs. The images can show structural changes in your heart that indicate mitral stenosis.
- Echocardiogram: Echocardiograms use sound waves to produce images of your heart. They can show narrowing of your mitral valve and how well blood travels through it.
- Electrocardiogram: This test measures the electrical activity of your heart. Certain changes in electrical activity can suggest an enlarged atrium, which may be a sign of mitral stenosis. It can also detect if you have developed atrial fibrillation.
- Cardiac catheterization: If you are diagnosed with mitral stenosis, your doctor may order this test to see how severe it is. For the test, your doctor inserts a thin tube, called a catheter, through a vessel in either your neck or the femoral (thigh) area and measures pressure inside your heart.
Mitral stenosis treatment
If your doctor diagnoses you with mitral stenosis, they may grade it from 1 to 4. In grade 1, the valve has minimal narrowing and a small amount of calcium buildup. By grade 4, the most severe, the valve has become very thick and calcified.
If your mitral stenosis is mild or does not cause bothersome symptoms, you may not need treatment. Your doctor will usually recommend annual checkups and regular tests to ensure your condition does not get worse, and they may recommend antibiotics before certain dental or medical procedures to prevent an infection like endocarditis from damaging your heart.
For more severe grades of mitral stenosis, your doctor may recommend medication, nonsurgical procedures or surgery.
Medication
Your doctor may prescribe various medications, depending on your symptoms and how severe they are. Medication can reduce your risk of complications, such as blood clots, which can cause heart attacks or strokes. Always tell your doctor if you experience any side effects.
Medications to treat symptoms include:
- Antiarrhythmic medicine: These can treat abnormal heart rhythms caused by mitral stenosis.
- Beta blockers: These drugs slow your heart rate and reduce blood pressure, lowering your risk of heart problems.
- Blood thinners: These prevent blood clots that could cause a stroke.
- Calcium channel blockers: These prevent calcium from entering the muscle cells of your heart and blood vessels, allowing them to relax.
- Diuretics: These reduce stress on your heart by removing excess fluid from your body.
Valvuloplasty
Valvuloplasty is a nonsurgical procedure that opens a narrowed mitral valve. It is also known as percutaneous mitral balloon commissurotomy or percutaneous mitral balloon valvotomy. Your doctor might recommend this as a less invasive alternative to surgery if your mitral valve is only slightly damaged.
Your doctor will insert a catheter into your vein and use it to move a small balloon through your bloodstream to your heart and mitral valve. Under the guidance of X-rays, the balloon is inflated to open the valve.
Surgery
If you have moderate to severe mitral stenosis, your doctor may recommend surgery to address the narrowing or to repair or replace a severely damaged mitral valve. Surgical options include:
- Commissurotomy: Commissurotomy separates the flaps or leaflets of your mitral valve, opening it to improve blood flow. If balloon commissurotomy is not suitable for you, this procedure may be performed as open surgery.
- Valve repair: Your surgeon may try to repair a faulty valve instead of replacing it. They may trim, shape, or rebuild your valve flaps to allow blood to flow better.
- Valve replacement: Your surgeon may replace a faulty valve with a mechanical one or a biological one from animal or human tissue.
Locations for mitral stenosis
Find the experienced, nationally recognized care you need for mitral stenosis and other heart valve diseases at Baylor Scott & White. We can help you find care in North and Central Texas at the location that meets your needs.
Baylor Scott & White Advanced Heart Failure Clinic - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Advanced Heart Failure Clinic - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Center for Thoracic Surgery - Tyler
1321 S Beckham Ave , Tyler, TX, 75702
Baylor Scott & White Cardiology Consultants of Texas - Greenville
4400 Interstate 30 W Ste 300, Greenville, TX, 75402
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Texas Cardiac Associates - Royse City
6257 FM 2642 Blvd Ste 100, Royse City, TX, 75189
Baylor Scott & White The Heart Hospital - McKinney
5268 W University Dr , McKinney, TX, 75071
Baylor Scott & White The Heart Group - McKinney
5236 W University Dr Ste 4450, McKinney, TX, 75071
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 7:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Legacy Heart Center - McKinney
5236 W University Dr Ste 4100, McKinney, TX, 75071
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Cardiac Surgery Specialists - McKinney
5236 W University Dr Ste 4900, McKinney, TX, 75071
Baylor Scott & White Arrhythmia Management - McKinney
5236 W University Dr POB I, Ste 4900, McKinney, TX, 75071
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - McKinney
5252 W University Dr Highway 380 at Lake Forest Drive, McKinney, TX, 75071
Baylor Scott & White Arrhythmia Management - Rockwall
1005 W Ralph Hall Pkwy Ste 225, Rockwall, TX, 75032
Baylor Scott & White Cardiovascular Specialists - Rockwall
6705 Heritage Pkwy Ste 202, Rockwall, TX, 75087
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Lake Pointe
6800 Scenic Dr , Rowlett, TX, 75088
Baylor Scott & White Center for Thoracic Surgery - Rockwall
6701 Heritage Pkwy Ste 130, Rockwall, TX, 75087
Baylor Scott & White Legacy Heart Center - Prosper
111 S Preston Rd Ste 10, Prosper, TX, 75078
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Prosper
111 S Preston Rd Ste 10, Prosper, TX, 75078
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Group - Prosper
111 S Preston Rd Ste 10, Prosper, TX, 75078
Baylor Scott & White Texas Cardiac Associates - Rowlett
7801 Lakeview Pkwy Ste 100, Rowlett, TX, 75088
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Denton Heart Group - Gainesville
201 N Interstate 35 Ste 140, Gainesville, TX, 76240
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Frisco at PGA Parkway
7600 Better Way , Frisco, TX, 75033
Baylor Scott & White The Heart Group - Frisco
4461 Coit Rd Ste 101, Frisco, TX, 75035
- Monday: 8:30 am - 4:30 pm
- Tuesday: 8:30 am - 4:30 pm
- Wednesday: 8:30 am - 4:30 pm
- Thursday: 8:30 am - 4:30 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White Medical Center - Centennial
12505 Lebanon Rd , Frisco, TX, 75035
Baylor Scott & White Legacy Heart Center - Garland
7217 Telecom Pkwy Ste 205, Garland, TX, 75044
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Garland
7217 Telecom Pkwy Ste 205, Garland, TX, 75044
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Texas Cardiac Associates - Forney
763 E US Hwy 80 Ste 240, Forney, TX, 75126
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Legacy Heart Center - Frisco
9990 Dallas Pkwy Ste 100, Frisco, TX, 75033
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Cardiovascular Consultants at The Star
3800 Gaylord Pkwy Ste 910, Frisco, TX, 75034
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Legacy Heart Center - Plano Preston Road
6601 Preston Rd , Plano, TX, 75024
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Frisco
5601 Warren Pkwy , Frisco, TX, 75034
Baylor Scott & White Legacy Heart Center - Plano Spring Creek Parkway
5655 W Spring Creek Pkwy Ste 155, Plano, TX, 75024
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Medical Center - Sunnyvale
231 S Collins Rd , Sunnyvale, TX, 75182
Baylor Scott & White Cardiovascular Consultants - Plano
6000 W Spring Creek Pkwy Ste 220, Plano, TX, 75024
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Plano
1820 Preston Park Blvd Ste 1450, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Cardiology Consultants of Texas - Mesquite
1575 Interstate 30 , Mesquite, TX, 75150
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White The Heart Hospital - Plano
1100 Allied Dr , Plano, TX, 75093
Baylor Scott & White Cardiac Surgery Specialists - Plano
4708 Alliance Blvd Pavilion I, Ste 540, Plano, TX, 75093
- Monday: 8:30 am - 4:30 pm
- Tuesday: 8:30 am - 4:30 pm
- Wednesday: 8:30 am - 4:30 pm
- Thursday: 8:30 am - 4:30 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White The Heart Group - Plano
4708 Alliance Blvd Pavilion I, Ste 465, Plano, TX, 75093
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Cardiovascular Consultants - Plano II
4708 Alliance Blvd Pavilion I, Ste 450 , Plano, TX, 75093
- Monday: 8:30 am - 4:45 pm
- Tuesday: 8:30 am - 4:45 pm
- Wednesday: 8:30 am - 4:45 pm
- Thursday: 8:30 am - 4:45 pm
- Friday: 8:30 am - 4:45 pm
Baylor Scott & White Cardiovascular Specialists - Mesquite
5308 N Galloway Ave Ste 201, Mesquite, TX, 75150
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital Heart Rhythm Center - Plano
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
Baylor Scott & White The Heart Hospital Heart Recovery Center - Plano
4716 Alliance Blvd Pavilion II, Ste 350, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital – Plano Structural Heart Center
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Global Heart Health Center
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
Baylor Scott & White The Heart Hospital Aortic Center - Plano
4716 Alliance Blvd Pavilion II, Ste 300, Plano, TX, 75093
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White The Heart Hospital Genetics Center - Plano
4716 Alliance Blvd Pavilion II, Ste 350, Plano, TX, 75093
Baylor Scott & White Medical Center - Plano
4700 Alliance Blvd , Plano, TX, 75093
Baylor Scott & White The Heart Group - Castle Hills
1700 FM 544 Ste 200, Lewisville, TX, 75056
Baylor Scott & White Cardiology Consultants of Texas - Park Cities
9101 N Central Expy Ste 300C, Dallas, TX, 75231
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 5:00 pm
Baylor Scott & White Arrhythmia Management - Denton
3333 Colorado Blvd , Denton, TX, 76210
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Frequently asked questions
-
Is mitral stenosis a diastolic murmur?
Yes, mitral stenosis causes a diastolic murmur. In mitral stenosis, the mitral valve is narrowed causing a turbulent blood flow which produces a rumbling diastolic murmur.
-
Can mitral stenosis be reversed?
Mitral stenosis is a lifelong condition. You cannot reverse it through medicine or lifestyle changes. However, you can treat the symptoms and reduce your risk of serious complications. Surgery and other procedures can address structural problems and improve blood flow through your heart.
-
Can mitral stenosis cause heart failure?
Yes, mitral stenosis can cause congestive heart failure. A narrowed valve can restrict blood flow through your heart, increasing stress on the heart and reducing its ability to pump oxygen-rich blood to the rest of your body.
-
Can mitral stenosis cause sudden death?
Mitral stenosis increases your risk for developing atrial fibrillation or heart failure, a condition that can cause sudden cardiac death. Mitral stenosis can also increase your chance of a stroke, another condition that can lead to sudden death.
-
How do you repair mitral stenosis?
Your doctor can repair mitral stenosis with procedures to open, repair or replace the valve. You can’t repair mitral stenosis with medications, but medications can help you manage symptoms.
-
What is the life expectancy of someone with mitral stenosis?
Life expectancy varies depending on your age and how severe your condition is. Many people live for years with no symptoms. Once symptoms develop, around 20% of people survive for 10 years. Those who develop pulmonary hypertension survive on average three years.
-
What happens if mitral stenosis is left untreated?
If left untreated, mitral stenosis can lead to severe complications, including infections, stroke and heart failure.
You may not need medical treatments if you have mild mitral stenosis, but your doctor can monitor you to see if the condition gets worse over time. If it does, treatments can help you control symptoms or address problems with your heart valve.