Understanding Rheumatic Mitral Valve Stenosis: Symptoms, Causes and Care

Written by Medicover Team and Medically Reviewed by Dr Jagadeesh Chandra Bose Y , Cardiologists

Causes
Find a Doctor
Diagnosis
Treatment
FAQs
Book an Appointment

1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Rheumatic mitral stenosis is a heart valve condition in which the mitral valve becomes narrowed due to damage caused by rheumatic fever. The mitral valve controls blood flow from the left atrium to the left ventricle. When the valve opening narrows, blood cannot flow normally through the heart.

Rheumatic fever usually develops after an untreated or inadequately treated streptococcal infection, such as strep throat. Over time, repeated inflammation can cause the mitral valve leaflets to become thickened, scarred and stiff. This may increase pressure in the left atrium and lungs and eventually lead to complications such as atrial fibrillation, pulmonary hypertension or heart failure.

What Are the Types of Rheumatic Mitral Stenosis?

Rheumatic mitral stenosis is commonly classified according to the severity of narrowing and its effect on blood flow through the heart.

Mild Rheumatic Mitral Valve Stenosis: The valve narrowing is limited and may cause few or no noticeable symptoms. Some people are diagnosed during routine heart examinations.
Moderate Rheumatic Mitral Valve Stenosis: The narrowing becomes more significant and may cause shortness of breath, fatigue or reduced exercise tolerance.
Severe Rheumatic Mitral Valve Stenosis: The valve opening is significantly narrowed, which can cause severe breathing difficulty, palpitations, pulmonary hypertension or heart failure.
Critical Mitral Valve Stenosis: Extreme narrowing of the valve opening, causing severe and life-threatening symptoms, requiring prompt medical intervention.

What Are the Symptoms of Rheumatic Mitral Valve Stenosis?

Symptoms may develop gradually as the mitral valve becomes narrower. Some people remain symptom-free for years before developing problems, especially during physical activity, pregnancy or illness.

Shortness of breath during physical activity or when lying flat
Fatigue and weakness
Chest pain or discomfort
Heart palpitations or an irregular heartbeat
Cough, sometimes with blood-streaked sputum
Swelling in the feet, ankles or legs
Dizziness or fainting
Frequent respiratory infections
Reduced ability to exercise or perform physical activities

What Causes Rheumatic Mitral Stenosis?

The main cause of rheumatic mitral stenosis is damage to the mitral valve following rheumatic fever. The condition usually develops gradually over several years or decades after the initial illness.

Rheumatic Fever

Rheumatic fever can develop after an untreated or inadequately treated group A streptococcal infection. The abnormal immune response may cause inflammation of the heart valves.

Valve Scarring and Thickening

Repeated or severe inflammation can cause the mitral valve leaflets to become thickened and scarred. The supporting structures of the valve may also fuse together, gradually narrowing the valve opening.

Recurrent Streptococcal Infections

Repeated episodes of streptococcal infection and rheumatic fever can cause further valve damage and increase the severity of mitral stenosis.

Genetic Susceptibility

Some people may have an inherited susceptibility that increases the likelihood of developing rheumatic fever and subsequent heart valve damage after a streptococcal infection.

When Should You See a Doctor for Rheumatic Mitral Stenosis?

Medical evaluation by a Cardiologist is important if breathing difficulty, fatigue, palpitations, or swelling develops, especially after a history of rheumatic fever. Early diagnosis can identify valve narrowing, monitor heart function, and help prevent complications such as pulmonary hypertension or heart failure.

You should see a doctor if you have:

Shortness of breath during activity or when lying flat
Persistent fatigue, palpitations or reduced exercise tolerance
Swelling in the feet, ankles or legs

Get medical help immediately if:

Severe breathing difficulty or sudden chest pain develops
Fainting or a rapid, irregular heartbeat occurs
You cough up blood or develop sudden severe weakness

These could be signs of a serious complication like heart failure, which needs urgent care.

No doctors found for Rheumatic Mitral Valve Stenosis in any location.

How Is Rheumatic Mitral Valve Stenosis Diagnosed?

Diagnosis involves reviewing symptoms and medical history, listening to the heart and using tests to assess the mitral valve, blood flow and heart function.

Medical History and Physical Examination

The healthcare provider asks about symptoms, previous rheumatic fever or streptococcal infections and listens for characteristic heart murmurs with a stethoscope.

Echocardiography

Echocardiography is the main test used to diagnose mitral stenosis. It shows the structure of the mitral valve, measures the valve opening and assesses the severity of narrowing.

Doppler Ultrasound

Doppler ultrasound measures blood flow across the mitral valve and helps determine the pressure difference caused by the narrowed opening.

Electrocardiogram

An electrocardiogram can detect abnormal heart rhythms, including atrial fibrillation, and signs of enlargement or strain in the heart chambers.

Chest X-Ray

A chest X-ray may show enlargement of the left atrium, changes in the heart's size or signs of fluid buildup and increased pressure in the lungs.

Cardiac Catheterization

Cardiac catheterization may be performed when other tests do not provide enough information or before certain procedures. It directly measures pressures within the heart chambers.

How Is Rheumatic Mitral Valve Stenosis Treated?

Treatment for rheumatic mitral stenosis aims to relieve symptoms, improve blood flow through the heart and prevent complications. The approach depends on the severity of valve narrowing, symptoms and overall heart function.

Medications

Medicines cannot reverse the narrowing of the mitral valve, but they can help manage symptoms and complications.

Diuretics: Help reduce fluid buildup in the lungs and legs.
Beta-Blockers or Other Heart Rate Medicines: Help slow the heart rate and improve blood flow through the narrowed valve.
Anticoagulants: May be prescribed to reduce the risk of blood clots and stroke, particularly in people with atrial fibrillation.
Antibiotics: May be used to treat streptococcal infections and prevent recurrent rheumatic fever when recommended.

Balloon Mitral Valvuloplasty

Balloon valvuloplasty is a minimally invasive procedure used to widen a narrowed mitral valve. A catheter with a balloon at its tip is guided to the valve, where the balloon is inflated to separate the fused valve leaflets.

Mitral Valve Repair

Surgical repair may be considered when the valve structure is suitable. The procedure aims to improve valve function while preserving the patient's natural valve.

Mitral Valve Replacement

When the valve is severely damaged and cannot be repaired, it may be replaced with a mechanical or biological valve.

Lifestyle and Follow-Up Care

Regular medical follow-up, appropriate physical activity and a heart-healthy diet can support overall cardiovascular health. The healthcare provider may also recommend limiting salt intake when fluid retention is present.

Your health is everything - prioritize your well-being today.

Consult Rheumatic Mitral Valve Stenosis Doctors Today

What Are the Risk Factors for Rheumatic Mitral Valve Stenosis?

Factors that increase the risk of rheumatic fever or recurrent streptococcal infections can also increase the likelihood of developing rheumatic mitral stenosis.

Previous Rheumatic Fever: A history of rheumatic fever is the main risk factor for rheumatic mitral stenosis.
Untreated Streptococcal Infections: Delayed or inadequate treatment can increase the risk of rheumatic fever.
Recurrent Rheumatic Fever: Repeated episodes can cause progressive damage to the mitral valve.
Overcrowded Living Conditions: Close contact can increase the spread of streptococcal infections.
Limited Access to Healthcare: Delayed diagnosis and treatment of strep infections may increase the risk.
Genetic Predisposition: A family history of rheumatic heart disease may increase susceptibility in some individuals.

What Are the Complications of Rheumatic Mitral Valve Stenosis?

Severe or untreated rheumatic mitral stenosis can increase pressure in the heart and lungs and may lead to serious cardiovascular complications.

Atrial Fibrillation: Enlargement of the left atrium can cause an irregular and often rapid heartbeat.
Blood Clots and Stroke: Abnormal blood flow and atrial fibrillation can increase the risk of clot formation.
Pulmonary Hypertension: Increased pressure can develop in the blood vessels of the lungs.
Heart Failure: The heart may eventually struggle to pump enough blood to meet the body's needs.
Pulmonary Edema: Fluid can accumulate in the lungs and cause severe breathing difficulty.
Right-Sided Heart Failure: Long-term pressure in the lungs can strain and weaken the right side of the heart.

How Can Rheumatic Mitral Stenosis Be Prevented?

Preventing rheumatic fever and recurrent episodes is the most effective way to reduce the risk of rheumatic mitral stenosis.

Seek prompt medical evaluation for persistent sore throat and suspected strep infections
Take prescribed antibiotics exactly as directed
Complete the full course of antibiotic treatment
Follow long-term antibiotic prevention if recommended after rheumatic fever
Attend regular heart check-ups after a history of rheumatic fever
Maintain good hygiene to reduce the spread of streptococcal infections
Follow the treatment plan for existing heart valve disease