Mitral stenosis
What is mitral stenosis?
Mitral stenosis is when the mitral valve is narrow or stiff and doesn’t fully open. This makes it hard for blood to get out of the heart and to the rest of the body. This can weaken the heart over time. With aging, calcium can build up around the valve, causing stenosis; however, this is rarely an issue requiring treatment.
Causes
The most common cause of mitral stenosis is:
Rheumatic fever
Other causes include:
Calcium buildup
Heart defects
Endocarditis
Rare conditions causing valve scarring (e.g. lupus, rheumatoid arthritis)
Symptoms
Mild and moderate mitral stenosis rarely cause symptoms. Even in severe cases, symptoms may take years to appear and may be difficult to recognize. They vary and are often dismissed as general signs of aging. Common symptoms include:
Shortness of breath
Fatigue
Make sure you monitor any changes using a symptom tracker and attend regular checkups with your healthcare provider.
Treatments
If your valve requires treatment, a range of options may be available. Your heart team should carefully explain the risks and benefits of each approach for you. Together, you and your heart team can make the best decision about the right treatment for you. Treatment options may include:
Mitral valve repair
Balloon valvuloplasty or valvotomy is a minimally invasive procedure in which a thin tube called a catheter, is used to temporarily insert a balloon, which widens the valve and separates the leaflets.
Commissurotomy is a surgical procedure to remove calcium deposits and other scar tissue from the valve.
Surgical mitral valve replacement
A surgical valve replacement is usually performed by open heart surgery or, if possible, minimally invasive surgery with smaller incisions. The surgeon removes the mitral valve and replaces it with either a mechanical valve or a tissue valve, which is sometimes called a bioprosthetic or biological valve.
When deciding which valve is right for you, here are some factors to consider:
Mechanical valves are made of carbon or metal and are very durable – they can last a lifetime. This means it is less likely that you will need a second valve replacement.
With a mechanical valve, you will need to take blood-thinning medications every day for the rest of your life, to reduce the risk of blood clots forming in the valve.
Blood thinners increase your risk of bleeding which is important if some of your daily activities, such as your job or hobbies, increase your risk of falls, bumps or bruises.
Mechanical valves may make a clicking sound that you may be able to hear.
Bioprosthetic valve replacements are made of animal tissue that is strong and flexible enough to last 10-20 years.
They usually don’t require high doses of long-term blood-thinning medications which means your risk of bleeding is lower.
There is a higher chance you may need another operation with a bioprosthetic valve.
Lifestyle changes
With all heart valve diseases, healthy habits can improve your health generally and reduce the strain on your heart from everyday activities. Maintaining a healthy weight, stopping smoking, and starting light exercise like walking can help your heart adapt to work better despite valve disease.
Medical management
Regular checkups to monitor your heart health.
Your heart team may prescribe medications to relieve your symptoms, reduce complications and/or manage risk factors. Medicines are not a cure for heart valve disease.
There is a lot to consider when deciding on treatment. These resources will help you ask the right questions and participate in decision making with your heart team.
Patient Stories
If you have been diagnosed with mitral stenosis, you are not alone. Learn from people who share their experience — and what they learned about diagnosis, treatment and recovery.
Frequently asked questions
If I have no symptoms, does that mean my heart valve disease is mild?
No. You can have severe valve disease and feel fine. That’s why it is important to have a healthcare provider to assess your heart regularly.
What do I do if my doctor detects a murmur?
If your healthcare provider detects a murmur during a regular check-up, they may arrange for you to have one or more follow-up tests to help identify the cause. A murmur is not always a cause for concern. You may have a mild form of heart valve disease or sometimes hearts produce a murmur with no apparent cause. The follow-up tests will determine if you have heart valve disease and how to treat it.
Do all heart valve diseases require surgery?
No. Many Canadians who are diagnosed with heart valve disease can live a normal life with lifestyle changes and minimal treatment. Mild and moderate heart valve conditions may never need surgery. Regular check-ups help identify when heart valve disease is worsening and give you time to consider treatment options.
Resources
Initial Consultation Guide
This guide will help you prepare for an appointment with your doctor and support an efficient, informative, and helpful consultation. It outlines the types of questions your doctor may ask you during the consultation, as well as questions you'll want to consider asking.
Shared decision making
People diagnosed with heart valve disease are often confronted with a wide range of treatment options. Shared decision-making involves doctors and patients working together to choose the most suitable treatment, based on the patient’s preferences and goals as well as clinical evidence and the care team’s expertise. These resources aim to support people with heart valve disease in participating in decision-making about their care.
Get the shared-decision making guide
Symptom Tracker
Our symptom tracker has been developed to help people who think they may have heart valve disease, or other cardiac conditions, prior to or during consultation periods with their doctor. It captures symptoms to help you and your doctor understand your health and assist with diagnosis and ongoing care planning.
There is life after treatment.
Each person’s path to recovery will look different. Your treatment plan will be unique to your needs, and likewise, your recovery — the time it takes to return to a normal activity level and adapt to lifestyle changes — may vary from what others experience. Taking time to recover, both physically and mentally, is an important part of your journey.