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.
Mitral valves that are still in fairly good
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.
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
Fatigue or weakness
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.
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.
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.
Robin Parks, MS
Kathleen M. Ariss, MS
Pat Truman, MATC
Primary Medical Reviewer
E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
March 18, 2008
WebMD Medical Reference from Healthwise
March 18, 2008
This information is not intended to replace the advice of a doctor.
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