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Mitral stenosis - Symptom

Alternative Names

Mitral valve obstruction

Symptoms:

There are often no symptoms in adults. However, symptoms may appear or get worse with exercise or any activity that raises the heart rate. In adults, symptoms usually develop between the ages of 20 and 50.

In infants and children, symptoms may be present from birth (congenital).

Symptoms may begin with an episode of atrial fibrillation or may be triggered by pregnancy or other stress on the body such as infection in the heart or lungs, or other heart disorders.

Symptoms may include:

Chest discomfort (rare)
- Tight, crushing, pressure, squeezing, constricting
- Radiates to the arm, neck, jaw, or other areas
- Increases with activity, decreases with rest
Cough, possibly bloody
Difficulty breathing during or after exercise or when lying flat; may wake up with difficulty breathing
Fatigue, tired easily
Frequent respiratory infections such as bronchitis
Poor growth in children
Sensation of feeling the heart beat (palpitations)
Swelling of feet or ankles

Signs and tests:

The health care provider will listen to the heart and lungs with a stethoscope. A distinctive murmur, snap, or other abnormal heart sound may be heard. The typical murmur is a rumbling sound that is heard over the heart during the resting phase of the heartbeat. The sound gets louder just before the heart begins to contract.

The exam may also reveal an irregular heartbeat or lung congestion. Blood pressure is usually normal.

In adults, mitral stenosis may be difficult to distinguish from left atrial myxoma (a tumor of the heart).

Narrowing or obstruction of the valve or swelling of the upper heart chambers may show on:

Cardiac catheterization
Chest x-ray
Doppler ultrasound
Echocardiogram
ECG (electrocardiogram)
MRI of the heart
Transesophageal echocardiogram (TEE)

Heart, section through the middle

Heart, front view

Mitral stenosis

Heart valves

Heart valve surgery - series

Reviewed last on: 5/12/2008
Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Otto CM, Bonow RO. Valvular heart disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: chap 62.

Karchmer AW. Infective Endocarditis. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo: WB Saunders; 2007: chap. 63.

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