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Mitral stenosis

  • Alternative Names

    Mitral valve obstruction


    In adults there may be no symptoms. Symptoms may, however, appear or get worse with exercise or any activity that raises the heart rate. In adults, symptoms usually develop between ages 20 - 50.

    Symptoms may begin with an episode of atrial fibrillation, or may be triggered by pregnancy or other stress on the body, such as infection in the heart or lungs, or other heart disorders.

    Symptoms may include:

    • Chest discomfort (rare)
      • Increases with activity, decreases with rest
      • Radiates to the arm, neck, jaw, or other areas
      • Tight, crushing, pressure, squeezing, constricting
    • Cough, possibly bloody (hemoptysis)
    • Difficulty breathing during or after exercise or when lying flat; may wake up with difficulty breathing
    • Fatigue, becoming tired easily
    • Frequent respiratory infections such as bronchitis
    • Sensation of feeling the heart beat (palpitations)
    • Swelling of feet or ankles

    In infants and children, symptoms may be present from birth (congenital), and almost always develop within the first 2 years of life. Symptoms include:

    • Bluish discoloration of the skin or mucus membranes (cyanosis)
    • Poor growth
    • Shortness of breath

    Signs and tests

    The health care provider will listen to the heart and lungs with a stethoscope. A distinctive murmur, snap, or other abnormal heart sound may be heard. The typical murmur is a rumbling sound that is heard over the heart during the resting phase of the heartbeat. The sound gets louder just before the heart begins to contract.

    The exam may also reveal an irregular heartbeat or lung congestion. Blood pressure is usually normal.

    Narrowing or obstruction of the valve or swelling of the upper heart chambers may show on:

    • Cardiac catheterization
    • Chest x-ray
    • Doppler ultrasound
    • Echocardiogram
    • ECG (electrocardiogram)
    • MRI of the heart
    • Transesophageal echocardiogram (TEE)