Mitral stenosis

Alternative names:

mitral valve obstruction

Symptoms:

• difficulty breathing
  • after exercise
  • when lying flat (orthopnea)
  • awakening at night with difficulty breathing

• cough
  • may have blood in the sputum (hemoptysis)

• fatigue, tired easily
• frequent respiratory infections (such as bronchitis)
• chest discomfort
  • tight, crushing, pressure, squeezing, constricting
  • radiates to the arm, neck, jaw, or other areas
  • increases with activity, decreases with rest

• sensation of feeling the heart beat (palpitations)
• swelling of feet or ankles

Note: There are often no symptoms, or symptoms may appear or worsen with exercise or increase in heart rate:

Signs and tests:

A stethoscope examination reveals a distinctive murmur, snap, or other abnormal heart sound. (The typical murmur is described as a rumbling apical diastolic murmur with pre-systolic accentuation. This means a rumbling sound is heard over the point of the heart during the resting phase of the heart beat, and it gets more pronounced just before the heart contraction begins).

Examination may also reveal irregular heartbeat or lung congestion. Blood pressure is usually normal. There may be vibration (thrill), or a tapping sensation may be noted on palpation over the heart. Mitral stenosis may be difficult to distinguish from left atrial myxoma (a tumor of the heart).

Narrowing or obstruction of the valve, or enlargement of the atrium may show on:

• echocardiogram
• Doppler ultrasound
• chest X-ray
• ECG, also often shows atrial fibrillation
• coronary angiography

This disease may also alter the results of the following tests:

• Swan-Ganz (left heart catheterization)
• nuclear ventriculography (MUGA or RNV)