A healthy heart and its corresponding parts are essential to the function of the cardiovascular system. The heart is located in the thorax, posterior to the sternum and superior surface of the diaphragm. It acts as a muscle pump as it expands and contracts in order to pump blood into blood vessels and then to the rest of the body. The heart has four chambers that are regulated by four valves: the mitral valve, tricuspid valve, aortic valve, and pulmonary valve. The mitral valve is often associated with disease and is more vulnerable then its counterpart the tricuspid valve. The mitral valve consists of an annulus, both posterior and anterior leaflets, and chordate that connect the leaflets to the papillary muscles. The three most common conditions affecting the mitral valve are stenosis, regurgitation, and prolapse.
One of the conditions affecting the mitral valve is mitral stenosis. Mitral stenosis is the narrowing or obstruction of the mitral valve and occurs when valve openings are smaller than normal due to stiff or fused leaflets. This obstruction prohibits the blood flow from the left atrium into the left ventricle during diastole and causes blood to collect in the atrium. Since the blood is unable to empty from the atrium, when the atrium tries to contract the atrium ends up stretching. As the atrium is being stretched, the electrical pathways that cause the heart to have a stable rhythm can become disturbed creating palpitations. It can also cause fatigue, dizziness, chest pain, and even coughing up blood. Mitral stenosis is usually associated with a rheumatic fever heart disease that was caused by an untreated streptococcal infection (strep throat).
With mitral stenosis your symptoms may vary. Either you may feel no symptoms at all or have very minimal ones. As a disease that can be within you for a prolonged amount of time the symptoms are not that serious or are not felt at all. some of the symptoms may include; shortness of breath (especially with exertion or when you lie down), fatigue (especially during increased physical activity), swollen feet or legs, heart palpitations, dizziness or fainting, coughing up blood, and chest discomfort or chest pain. Mitral stenosis is always worsened with hard exercise or work, for the body is working harder. They may even be triggered by physical stresses, such as pregnancy or infections. Mitral stenosis usually shows up between the ages of 15-45 in developed nations, but can occur in childhood as well. The best way to prevent mitral valve stenosis is to prevent its most common cause, rheumatic fever. You can do this by making sure you see your doctor for sore throats. Untreated strep throat infections can develop into rheumatic fever. Fortunately, strep throat is usually easily treated with antibiotics.
However, the wide availability of antibiotics has drastically decreased rheumatic fevers prevalence in industrialized nations. Other causes of mitral stenosis include infective endocarditis, rheumatoid arthritis, systemic lupus erythematous, carcinoid hearty disease, and severe calcification of the mitral annulus. There are several medical treatment options for mitral stenosis. Medical therapy has no role in altering the natural history or delaying the need for surgery in patients with mitral stenosis. At the most medical treatment will delay surgery and in most cases make living with the disease a little bit more bearable. treatment is the use of medications such as calcium channel blockers and beta blockers to slow down the heart rate, this allows more time for the blood to move from the left atrium to the left ventricle. While this does allow some patients to feel better, it does not slow the progression of the disease. The second medical option involves the use of anticoagulants like warfarin to thin the blood allowing it to flow easier. This option does help prevent strokes and thromboembolism, especially in patients with irregular heartbeats.
In addition to drug treatments, there are several surgical options. Percutaneous mitral balloon valvotomy (PMBV), is a surgical treatment that works well for patients whose valves do not leak to severely and are not calcified is. Valvotomy involves using a catheter to inflate a balloon across the stenotic valve to split commissures and increase valve area. Another surgical option is mitral valve repair or replacement (MVR). Mitral valve repair is more difficult and in many cases does not correct mitral regurgitation. On the other hand, repair has several benefits including better preservation of LV function, lower operative and long-term mortality, no long term dependency on anticoagulation medicine, and a reduced risk of infective endocarditis.
Mitral stenosis can cause many other complications to the human body. As the heart goes into over drive working extra hard to deal with the stenosis, other complications can arise. some of the side effects are; pulmonary hypertension, heart failure, heart enlargement, atrial fibrillation, and blood clots. This will slow down the healing process of the mitral stenosis and also take a toll on your body.
Mitral valve stenosis is a progressive disease, although it starts out slow overtime it will take over the whole body. The prevalence of rheumatic disease is higher in developing nations than in the United States. Although a progressive decease with proper care and treatment there is a higher chance of survival.