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Monitoring mitral valve stenosis that has no symptoms

When you are diagnosed with mitral valve stenosis, you may have no symptoms. This first stage of the disease, called the asymptomatic phase, can last for 10 to 20 years. There are no symptoms because the mitral valve, whose normal area is 4.0 cm2 to 5.0 cm2, usually must narrow to 2 cm2 before symptoms develop. You may also remain asymptomatic even after your mitral valve has narrowed beyond this threshold.

But even if you have no symptoms and feel fine, there are several things you need to keep in mind.

Regular medical screening

Despite a lack of visible signs, serious damage can still occur while you are asymptomatic, and you still may need to have surgery or other medical treatment at this time. Your doctor may suggest surgery if you have:1

  • A higher risk of dangerous blood clots (thromboembolism). This includes people with an irregular heart rhythm called atrial fibrillation, as well as those who have had a blood clot before.
  • High blood pressure in the lungs (pulmonary hypertension).
  • Mitral valves that are still in fairly good condition.

Your doctor may recommend surgery if you are planning to have another surgery (not on your heart), if you are pregnant, or if you are planning a pregnancy.

Also, if your stenosis is moderate to severe and you develop atrial fibrillation, you may need surgery.

To make sure that you do not have any of the conditions described above, it is important that you visit your doctor regularly to monitor the progression of your stenosis and watch out for any complications.

In addition to visiting your doctor regularly to screen for symptoms of mitral valve stenosis, you also need to watch carefully for its symptoms:

  • Pounding of the heart (palpitations)
  • Fatigue or weakness
  • Shortness of breath
  • Coughing up blood

It may be difficult to detect some symptoms of mitral valve stenosis because they can be mild or be caused by another condition. For example, a condition such as asthma could also force you to experience shortness of breath. For this reason, you should contact your doctor if you think you are experiencing symptoms of mitral valve stenosis.

Some people may experience an embolism (the blockage of an artery by a blood clot, such as a stroke) as their first symptom of mitral valve stenosis. If a thrombus (clot) breaks free from the surface of your heart and travels through your bloodstream, it becomes an embolism. If the embolism blocks one of your blood vessels and cuts off blood supply to an area of your body, it is called an embolic event.

Rheumatic fever

After you have had rheumatic fever, you may need to take preventive antibiotics on an ongoing basis to prevent a recurrence. This is especially important if you had this illness while you were a child, as it can recur and may make heart valve damage, such as mitral valve stenosis, worse.

Although rheumatic fever is rare in the United States, it can be contracted while traveling in a country where it is still prevalent. You may also contract rheumatic fever if you have regular contact with large groups of people who potentially carry the type of bacteria (streptococcus) that causes rheumatic fever. The same bacteria causes strep throat, so you need to be wary if you have regular contact with young children.

If you have never had rheumatic fever but do have mitral valve stenosis, you still need to be concerned, particularly if you have regular contact with those who may carry the bacteria that causes it. If you do come down with strep throat, it should be treated promptly.

Preventive antibiotics for rheumatic fever may consist of either daily or weekly doses of antibiotics.


  1. Bonow RO, et al. (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients with Valvular Heart Disease). Circulation, 114(5): e84-e231.

Author Robin Parks, MS
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Last Updated March 18, 2008

WebMD Medical Reference from Healthwise

Last Updated: March 18, 2008
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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