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Complications

By Mayo Clinic staff

Whatever the cause, a narrowed mitral valve limits blood flow in the same way a narrow funnel spout limits the flow of fluid through a funnel. In mitral valve stenosis, blood has a difficult time flowing from the left atrium to the left ventricle. Pressure builds up in the left atrium, and the chamber may enlarge. Blood may back up into your lungs, leading to lung congestion and shortness of breath. In addition, the enlarged left atrium may become prone to a heart rhythm irregularity called atrial fibrillation. In atrial fibrillation, the upper chambers (atria) of the heart beat chaotically and inefficiently.

Like other heart valve problems, mitral valve stenosis can weaken your heart and decrease how efficiently it pumps blood. Mitral valve stenosis reduces the amount of blood that flows forward through your heart and out to the rest of your body.

Left unchecked, mitral valve stenosis can lead to complications such as:

  • Heart failure. Heart failure is a condition in which your heart is damaged and can't pump enough blood to meet your body's needs. A narrowed mitral valve interferes with blood flow through your heart and from your heart out to the rest of your body. In addition, pressure builds up in your lungs, leading to fluid accumulation. Eventually this places a strain on the right side of the heart, which leads to fluid buildup in either your ankles or abdomen or both areas (edema).
  • Heart enlargement. The pressure buildup of mitral valve stenosis results in enlargement of your heart's upper left chamber (atrium). At first this change helps your heart pump more efficiently, but eventually, it damages your heart's overall health. Additionally, pressure can build up in your lungs and cause pulmonary congestion and hypertension.
  • Atrial fibrillation. In mitral valve stenosis, the stretching and enlargement of your heart's left atrium may lead to a heart rhythm irregularity called atrial fibrillation. In atrial fibrillation, the upper chambers of your heart beat chaotically and too quickly.
  • Blood clots. Left untreated, atrial fibrillation can put you at risk of blood clots forming in the upper left chamber of your heart, where blood pools in mitral valve stenosis. Blood clots from your heart may break loose and travel to other parts of your body, causing serious problems. For example, a blood clot that travels to your brain and blocks a blood vessel there could cause a stroke. A transesophageal echocardiogram can help determine whether blood clots have formed in a heart with a narrowed mitral valve.
  • Lung congestion. Another possible complication of mitral valve stenosis is pulmonary edema — a condition in which blood and fluid back up into your lungs. This causes congestion of the lungs, leading to shortness of breath and, sometimes, coughing up of blood-tinged sputum.
Preparing for your appointment Risk factors
References
  1. Otto CM. Pathophysiology and clinical features of mitral stenosis. http://www.uptodate.com/home/index.html. Accessed July 3, 2009.
  2. Carabello BA. Valvular heart disease. In: Goldman L, et al., eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/148441160-6/860446560/1492/318.html#4-u1.0-B978-1-4160-2805-5..50080-X_3105. Accessed July 3, 2009.
  3. Ferri FF. Mitral stenosis. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/148441160-8/860527324/1701/373.html#4-u1.0-B978-0-323-04134-8..50016-1--cesec452_7951. Accessed July 3, 2009.
  4. Mitral stenosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec07/ch076/ch076f.html. Accessed July 3, 2009.
  5. Sorrentino MJ. Medical management and indications for intervention in mitral stenosis. http://www.uptodate.com/home/index.html. Accessed July 3, 2009.
  6. Sorrentino MJ. Surgical management of mitral stenosis. http://www.uptodate.com/home/index.html. Accessed July 3, 2009.
  7. Am I at risk of developing arrhythmias? American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=562. Accessed July 3, 2009.
  8. Ardehali R, et al. Valvular heart disease. In: Nilsson KR, et al. The Osler Medical Handbook. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/148441160-4/860446560/1387/28.html#4-u1.0-B0-323-03748-8..50017-8_181. Accessed July 3, 2009.
  9. Living with arrhythmia. American Heart Association. http://www.nhlbi.nih.gov/health/dci/Diseases/arr/arr_livingwith.html. Accessed July 3, 2009.
  10. Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. July 19, 2009.

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Sept. 18, 2009

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