Department of cardiac muscle pathology and transplantation of organs and tissues

Mitral stenosis

Mitral valve stenosis: causes, symptoms, diagnosis and treatment.

Mitral stenosis (MS) is a pathological narrowing of the foramen between the left atrium and the left ventricle, which causes an increase in the functional load on the left atrium, and later on the right chambers of the heart with the development of heart failure.

Etiology

Rheumatism is the most common cause of valvular heart disease, including MS. Also, the congenital defects, postinfectious conditions (infectious endocarditis, myocarditis, syphilis, brucellosis), postinfarction cicatricial as well as fibrotic changes due to autoimmune lesion of mitral valve structures, lead to narrowing of the left atrioventricular orifice. Atherosclerosis with calcification of valve flaps can also lead to MS. Some parasitic diseases, neoplastic process, posttraumatic and postoperative scarring of the MV can be an etiological factor in the development of MS, but much less common.

Clinic

Mitral stenosis almost always proceeds asymptomatically until the myocardium is capable of compensatory remodeling. In the beginning, the symptoms of increased load on the heart muscle in the form of tachycardia, arrhythmias, anginal pains, shortness of breath, reduced tolerance to physical exertion appear. After the exhaustion of compensation mechanisms, the symptoms of heart failure grow: shortness of breath increases, cough, acrocyanosis and edematous syndrome with a tendency to increase from the lower limbs to the thorax appear. Circulatory insufficiency, pulmonary edema develop. May cause thromboembolia of the pulmonary artery (TEPA).

Diagnostics

  • Checkup, physical examination (percussion, palpation, auscultation, blood pressure check);
  • Laboratory tests (rheumatological tests, serological diagnostics (RW, antibodies to bacteria, helminths), lipid profile, coagulation profile);
  • X-ray study of the thoracic organs in several projections;
  • Coronary angiography;
  • Phonocardiography;
  • ECG;
  • Ultrasound of the heart and abdomen.

Treatment

With stenosis up to 1.5 cm2, correction of the condition with the medications is possible. It’s aimed on prevention the progression of MS (treatment of a disease that became an etiological factor in the occurence of MS), prevention of TEPA (anticoagulants), as well as optimizing the work of the heart (beta-blockers, diuretics).
Surgical treatment is performed with stenosis of III-IV st.
1. Minimally invasive methods: balloon dilatation of the mitral orifice, balloon valvuloplasty and commissurotomy (performed with moderate damage of MV structures, for young people, pregnant women);
2. Full-scale surgical treatment: transthoracic commissurotomy, mitral valve replacement.

Contacts

 

02660, Kiev city,

Bratyslavka street, 5a

Phone.: +380975444655