(Mitral Valve Stenosis—Child)
DefinitionMitral stenosis is a narrowing of the mitral valve in the heart. The mitral valve is in the left side of the heart between the upper and lower chambers of the heart. When working properly, the valve helps to keep blood flowing in the right direction from the upper to the lower chambers.Mitral stenosis makes it difficult for blood to move from the upper and lower chambers. This means there is less blood for the lower chamber to pump out to the body. The blood can also back up in the upper chamber and push back into the lungs.
|Mitral Valve Stenosis|
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CausesThe most common cause of mitral stenosis is rheumatic fever . This infection may develop after strep throat or scarlet fever. It can scar the heart valves. Mitral stenosis may develop 5-10 years after this infection occurs. Less common or rare causes include:
- Birth defect
- Blood clots
- Infective endocarditis
- Other growths that block blood flow through the mitral valve
Risk FactorsThe main risk factor for mitral stenosis is rheumatic fever. Other risk factors may include:
- Being born with mitral valve problems
- Having other health problems that affect blood flow in the heart
SymptomsSymptoms are caused by the problems with blood flow and may include:
- Difficulty breathing, especially during exercise and when lying flat
- Waking up short of breath in the middle of the night
- Sensation of rapid or irregular heartbeat
- Cough with exertion
- Coughing up blood
- Swelling of the legs or feet
- Frequent respiratory infections
- Lightheadedness, fainting
- Chest pain, like squeezing, pressure, or tightness (rare)
DiagnosisYou will be asked about your child’s symptoms and medical history. A physical exam will be done.Images may be taken of your child's heart. This can be done with:
- Chest x-ray
- Transesophageal echocardiogram —a tube that runs from the mouth into the stomach to better examine the mitral valve
- Cardiac catheterization
TreatmentIf your child has mild mitral stenosis, immediate treatment may not be needed. Your child's condition will be monitored to look for potential problems. Other treatment options include:
MedicationsCertain medications may be given to improve heart function. The medications may help control the heart's rhythm and prevent the build up of fluid in the body.Antibiotics may be needed to treat certain infections.
SurgeryYour child may need surgery to prevent heart damage. Common types of heart valve surgery include:
- Mitral valvulotomy—A surgical cut is made in the stenotic mitral valve to allow the valve to open wider
- Balloon valvuloplasty —A balloon is inflated in the valve to stretch out the surrounding tissue. This may provide temporary relief of symptoms, but the valve may become blocked again.
- Mitral valve replacement—the valve is replaced with a mechanical or tissue valve
Complication ManagementThere are several steps your child can take to avoid some of the complications of mitral stenosis:
- Get regular medical care. This includes basic checkups and heart tests.
- Take antibiotics before any dental cleaning, dental work, or other invasive procedures if it is recommended by your doctor. Not all patients with mitral stenosis need antibiotics for these procedures.
- Eat a healthy diet that is low in salt. Work with the doctor or dietitian to plan a healthy diet for your child. This may help decrease the pressure in your child’s heart and improve symptoms.
- Monitor blood pressure. Inform the doctor if your child seems to be developing high blood pressure .
PreventionMost cases of mitral stenosis can be prevented by preventing rheumatic fever:
- Treat strep throat infections right away to avoid rheumatic fever, which can cause scarring of the heart valve.
- Always make sure your child finishes all of the antibiotics given, even if symptoms improve.
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Canadian Family Physician
Mitral stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 20, 2014. Accessed November 3, 2014.
Mitral valve abnormalities. Seattle Children’s Hospital website. Available at: http://www.seattlechildrens.org/medical-conditions/heart-blood-conditions/mitral-valve-abnormalities-symptoms/. Accessed November 3, 2014.
Shipton B, Wahba H. Valvular heart disease: review and update. Am Fam Physician. 20011;63:2201.
- Reviewer: Kari Kassir, MD
- Review Date: 12/2014
- Update Date: 12/20/2014
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