Mitral Valve Stenosis

Mitral valve stenosis, also referred to as mitral stenosis, is a congenital heart defect in which the mitral valve is narrower than normal, causing the valve to not open properly and block the flow of blood into the left ventricle (main pumping chamber of the heart).

About Mitral Valve Stenosis

The heart has four chambers, with two collecting chambers (atria) and two pumping chambers (ventricles). Four different valves of the heart control the flow of blood through the heart. The mitral valve is the valve that sits between the left atrium and the left ventricle.

A normal mitral valve is made up of two thin leaflets (flaps) and the valve opens to allow blood to flow from the left atrium to the left ventricle and closes to keep blood from leaking back into the atrium. Mitral valve stenosis occurs when the mitral valve is narrower than normal, causing the valve to block the flow of blood into the left ventricle. This causes the heart to work harder to pump blood through the valve.

Symptoms of Mitral Valve Stenosis

Symptoms of mitral valve stenosis vary depending on the severity of the narrowing.

Symptoms of mitral stenosis may include:

• Fatigue
• Frequent lung infections
• Irregular heartbeats or palpitations
• Poor weight gain
• Shortness of breath
• Tiring easily during exercise (for babies, this includes during feeding)

Diagnosing Mitral Valve Stenosis

During physical examinations, your child’s doctor listens to your child’s heart and lungs and may detect a heart murmur, which are extra sounds heard throughout the cardiac cycle due to increased blood flow. If your pediatrician suspects increased blood flow, a recommendation to see a pediatric cardiologist may be made. Your doctor may also refer you to a pediatric cardiologist if your child is breathing fast, has poor exercise tolerance (for babies, this includes poor feeding), or has an enlarged liver.

Tests performed when diagnosing mitral stenosis may include:

• Cardiac Catheterization: During cardiac catheterization, a small catheter (thin tube) is inserted into a larger blood vessel, typically in the groin, and guided to the heart where blood pressure and oxygen measurements can be taken in the aorta and pulmonary artery as well as the four chambers of the heart. A dye can also be injected through the tube to make the heart’s structure more visible on an X-ray.
• Cardiac MRI or CT Scan: A cardiac MRI or CT scan is used to take more detailed images of the heart to help define the anatomy and detect anomalies. A cardiac MRI or CT scan can help determine exactly where the coronary arteries arise.
• Chest X-Ray: A chest X-ray produces an image of the tissue and bones in the heart and lungs and helps your provider assess the shape, size, and structure of the heart and lungs as well as the aeration of or any congestion in the lungs.
• Echocardiogram: An echocardiogram uses ultrasound technology to create a moving image of the heart and its valves, allowing your provider to assess the structure and function of the heart. An echocardiogram also helps provide information about blood flow and how well the heart is pumping blood.
• Electrocardiogram (ECG or EKG): An electrocardiogram uses electrodes that are placed on the body to record the electrical activity taking place in the heart. An ECG/EKG test helps detect abnormal rhythms, such as cardiac arrhythmias, stress on the heart, and damage to the heart muscles.

Treating Mitral Valve Stenosis

Treatment options for children with mitral valve stenosis are dependent upon the severity of the stenosis and can involve observation and monitoring, prescription medication, and/or a heart catheterization or surgery.

Treatment options for mitral stenosis may include:

• Observation: Treatment may involve careful monitoring of the mitral valve through frequent visits with a pediatric cardiologist to ensure the valve continues to function.
• Antibiotics: Antibiotics may be prescribed to prevent rheumatic fever caused by the mitral stenosis.
• Antiarrhythmics: Antiarrhythmics may be prescribed to treat irregular heart rhythms associated with the mitral stenosis.
• Anticoagulants: Anticoagulants, such as blood thinners, may be prescribed to help prevent blood clots.
• Beta Blockers, Calcium Channel Blockers, and Digitalis Glycosides: These medications can help slow the heart rate to allow the heart to fill more effectively despite the narrowing.
• Diuretics: Diuretics may be prescribed to reduce fluid buildup in the lungs.
• Balloon Valvuloplasty: Using the same method as cardiac catheterization, a small tube can be inserted through a blood vessel in the groin and guided to the heart. A balloon can be pushed through the tube and inflated in the mitral valve to stretch the valve open and improve the narrowing.
• Surgery: While preserving the valve is top priority, the valve may need to be surgically replaced with an artificial valve.

Care Team Approach

The Texas Center for Pediatric and Congenital Heart Disease, a clinical partnership between Dell Children’s Medical Center and UT Health Austin, takes a multidisciplinary approach to your child’s care. This means your child and your family will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include pediatric cardiologists, cardiothoracic surgeons, interventional cardiologists, critical care specialists, hospitalists, anesthesiologists, perfusionists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical and occupational therapists, pharmacists, and more, who work together to provide unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your child’s care with referring physicians and other partners in the community to ensure that we are providing comprehensive, whole-person care.

Learn More About Your Care Team