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Mitral stenosis - Symptom

Alternative Names

Mitral valve obstruction

Symptoms:

In adults there may be no symptoms. Symptoms may, however, appear or get worse with exercise or any activity that raises the heart rate. In adults, symptoms usually develop between ages 20 - 50.

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

In infants and children, symptoms may be present from birth (congenital), and almost always develop within the first 2 years of life. Symptoms include:

Bluish discoloration of the skin or mucus membranes (cyanosis)
Poor growth
Shortness of breath

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.

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: 5/6/2010
Issam Mikati, MD, Associate Professor of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL. 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.

Curtin RJ, Griffin BP. Mitral valve disease. In: Cleveland Clinic: Current Clinical Medicine 2009, 1st ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 21.

Nishimura RA, Carabello BA, Faxon DP, et al. ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52(8):676-685.

Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr., Faxon DP, Freed MD, et al; 2006 Writing Committee Members; American College of Cardiology/American Heart Association Task Force. 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Asssociation Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients with Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118:e523-e661.

Valvular heart disease. In: Park MK, ed. Pediatric Cardiology for Practitioners. 5th ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 21.

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