Mitral Stenosis

About Your Diagnosis
Mitral stenosis is abnormal narrowing of the mitral valve. The mitral valve is located between the left atrium and left ventricle. If this valve is narrow, the left atrium must pump harder to move its blood into the left ventricle. If the left atrium cannot empty itself properly, blood backs up into the right heart system and fluid leaks into the lungs. Mitral stenosis is most often caused by scarring of the valve from previous rheumatic fever. Rheumatic fever comes from a bacterial infection. Mitral stenosis occurs two to four times more often among women than among men.

Living With Your Diagnosis
Symptoms usually begin many years after the rheumatic fever. Symptoms of right heart failure in mitral stenosis include difficulty with breathing (especially when lying down) or edema (swelling in the legs or abdomen). Other symptoms include irregular heartbeat, coughing up blood, and abdominal or chest pain. Atrial fibrillation may develop, and the atrium does not contract normally causing blood to pool in the atrium. Clots may form and can travel out of the heart when normal contractions resume. Because of this, some patients undergo an operation to have their mitral valve widened or replaced.

Treatment
Treatment with antibiotics before and after dental and surgical procedures is required to prevent infection in the heart muscle (endocarditis). Digitalis helps manage atrial fibrillation. Anticoagulant drugs prevent clots from forming. Diuretics reduce the fluid in the blood. Other heart and lung conditions must be managed. Side effects of these medications include allergic reactions, nausea, vomiting, diarrhea, and dehydration from diuretics. Anticoagulants may cause easy bruising and prolonged bleeding from cuts.

The DOs
•Take your medications as directed.
•Change your diet to moderate salt restriction (do not add salt to your food).
•Exercise as tolerated.
•Seek the care of a cardiologist for monitoring if you are pregnant or planning pregnancy.

The DON’Ts
•Do not ignore worsening symptoms.
•Do not forget to ask your doctor about antibiotics for dental and surgical procedures.

When to Call Your Doctor
•If you have side effects of medications.
•If you have new or worsening symptoms such as chest pain, shortness of breath, or swelling in the legs or abdomen.
•If you are taking anticoagulants and have a cut that does not stop bleeding or if you sustain a head injury.