"Valve replacement can be made of many different materials, some of which can last for decades and some of which can wear out and require replacement".
DR. GREGORIO RÁBAGO JUAN-ARACIL
DIRECTOR. CARDIAC SURGERY DEPARTMENT
Mitral stenosis occurs when the mitral valve does not open properly, preventing some of the blood from the atrium from passing into the left ventricle.
An increase in residual blood volume is generated in the atrium, which adapts to the new situation by dilating (enlarging).
As the valve area becomes smaller, pressure builds up and blood can flow back into the lungs, causing pulmonary edema (fluid in the lung tissues).
We are a reference center in different diagnostic techniques and surgical treatments to solve valve diseases.
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What are the symptoms of mitral stenosis?
Symptoms may appear or worsen with exercise or any activity that raises the heart rate.
They may begin with an episode of atrial fibrillation or may be triggered by pregnancy or other bodily stress, such as infection in the lungs or heart or other heart disorders.
- Chest discomfort (rare).
- Coughing, possibly with blood.
- Shortness of breath during or after exercise or while lying down; may wake up with trouble breathing.
- Fatigue, tiredness easily.
- Frequent respiratory infections (such as bronchitis).
- Poor growth in children.
- Tactile sensation of heartbeat (palpitations).
- Swelling of the feet or ankles (edema).
Learn how valve diseases are diagnosed and treated (available in spanish)
The most common symptoms are:
- Breathing difficulty.
- Fatigue, tiredness with ease.
- Swelling of the feet or ankles.
- Tactile sensation of the heartbeat (palpitations).
Do you have any of these symptoms?
You may have mitral stenosis
What are the causes of mitral stenosis?
The most common cause is rheumatic fever. This condition of the upper airways, today has almost disappeared in Spain, thanks to the treatment and vaccine against infections produced by the Hemolytic Strep B.
However, it is still frequent in African and Southeast Asian countries, where it is endemic and heart conditions are seen in children and adolescents.
While the heart is affected in approximately 50% of cases, in 99% of mitral stenoses, rheumatic fever is the cause.
What is the prognosis of mitral stenosis?
Generally, the prognosis of valve diseases is favorable with treatment, so it is very important to choose the time of surgical and interventional treatment that radically change the natural evolution of the disease.
The decision to intervene is made before irreversible sequelae occur on the heart itself, such as the exaggerated dilation of the cardiac chambers, especially the left ventricle, which can lead to the appearance of chronic heart failure despite surgical treatment.
How is mitral stenosis diagnosed?
In diagnosing mitral stenosis, the physician will listen to the heart and lungs with a stethoscope.
A characteristic murmur can be heard that may radiate into the carotid (neck arteries) that are in continuity with the aorta, and the carotid heartbeat may be decreased in amplitude.
The exam may also reveal an irregular heartbeat or lung congestion. Blood pressure is usually normal.
The diagnosis can be confirmed by electrocardiogram, chest x-ray, echocardiogram or cardiac catheterization.
How is mitral stenosis treated?
Treatment depends on the symptoms and condition of the heart and lungs.
People with mild or no symptoms at all may not need treatment and hospitalization may be necessary to make a diagnosis or to treat severe symptoms.
Medications used include diuretics, nitrates or beta-blockers. Digoxin can be used to treat atrial fibrillation. Anticoagulants are used to prevent blood clots from forming and traveling to other parts of the body.
Some patients may need mitral valve surgery to lift the obstruction. Currently, the first treatment is the percutaneous dilation of the mitral valve using a balloon.
This operation is called "percutaneous mitral commissary". During this procedure, a catheter (tube) is inserted into a vein, usually in the leg up to the heart.
A balloon on the tip of the catheter is inflated, widening the mitral valve and improving blood flow. This procedure is less likely to work in patients with severely damaged mitral valves.
In cases in which this technique is contraindicated, such as significant calcification of any of the components of the mitral valve (ring, leaflets, chordae tendineae or pillars), heart surgery is indicated to replace the valve.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Cardiology
of the Clínica Universidad de Navarra
The Department of Cardiology of the Clinica Universidad de Navarra is a center of reference in different diagnostic techniques and coronary treatments.
We have been the first center in Europe to place a pacemaker by means of a catheterization without the need to open the chest, for cases of severe heart failure.
The Cardiology Department of the Clinic collaborates with the Radiology and Cardiac Surgery Departments to achieve a quick and precise diagnosis of the patient.
Why at the Clinica?
- Specialized Arrhythmia Unit of national reference.
- Unit of Hemodynamics and Interventionist Cardiology equipped with the best technology.
- Cardiac Imaging Unit to achieve the highest diagnostic accuracy.