How is mitral valve stenosis diagnosed?
Mitral valve stenosis is usually detected by a physician listening to heart sounds. Normal heart valves open silently to permit the flow of blood. A stenotic valve makes a snapping sound followed by a "rumbling" murmur. The condition can be confirmed with a chest x ray and an electrocardiogram, both of which will show an enlarged atrium. Echocardiography, which produces images of the heart's structure, is also helpful in making the diagnosis. If surgery is necessary, cardiac
catheterization may be done to fully evaluate the heart before the operation.
In most cases, the diagnosis of mitral stenosis is most easily made by echocardiography, which shows decreased opening of the mitral valve leaflets, and blunted flow of blood in early diastole. The trans-mitral gradient as measured by doppler echocardiography is the gold standard in the evaluation of the severity of mitral stenosis.
Another method of measuring the severity of mitral stenosis is the simultaneous left heart catheterization and right heart catheterization. The right heart catheterization (commonly known as swan ganz catheterization) gives the physician the mean pulmonary capilary wedge pressure, which is a reflection of the left atrial pressure. The left heart catheterization, on the other hand, gives the pressure in the left ventricle. By simultaneously taking these pressures, it is possible to determine the gradient between the left atrium and left atrium during ventricular diastole, which is a marker for the severity of mitral stenosis. This method of evaluating mitral stenosis tend to over-estimate the degree of mitral stenosis, however, because of the time lag in the pressure tracings seen on the right heart catheterization and the slow y descent seen on the wedge tracings. If a trans-septal punture is made during right heart catheterization, however, the pressure gradient can accurately quantify the severity of mitral stenosis.
Upon auscultation of an individual with mitral stenosis, an opening snap is heard after the A2 component of the second heart sound (S2). The opening snap corelates to the opening of the mitral valve. The mitral valve opens when the pressure in the left atrium is greater than the pressure in the left ventricle. This happens in ventricular diastole (after closure of the aortic valve), when the pressure in the ventricle precipitously drops. In individuals with mitral stenosis, the pressure in the left atrium correlates with the severity of the mitral stenosis. As the severity of the mitral stenosis increases, the pressure in the left atrium increases, and the mitral valve opens earlier in ventricular diastole. This means that the more severe the mitral stenosis, the shorter the gap between A2 and the opening snap. |
More information on mitral valve diseases (mitral valve prolapse, mitral valve regurgitation, mitral stenosis)
What is mitral valve disease? - There are many diseases which affect the mitral valve and its supporting structures. The most common disorder of the mitral valve is the partial backflow.
What is mitral valve prolapse? - Mitral valve prolapse (MVP) is a heart valve condition marked by the displacement of a thickened mitral valve leaflet into the left atrium during systole.
What causes mitral valve prolapse? - The cause of mitral valve prolapse is unknown. It is more common in people with low body weight and low blood pressure.
What're the symptoms of mitral valve prolapse? - Symptoms of mitral valve prolapse include fatigue, palpitations, chest pain, anxiety, migraine headaches, and even stroke.
How is mitral valve prolapse diagnosed? - Mitral valve prolapse is diagnosed in the course of a physical examination. Echocardiography is useful in diagnosing a prolapsed mitral valve.
What're the treatments for mitral valve prolapse? - Most people with mitral valve prolapse (MVP) do not have symptoms or need treatment. Mitral valve prolapse can be treated with surgical replacement of the mitral valve.
What is mitral valve regurgitation? - Mitral valve regurgitation happens when some of the blood in your heart leaks from the left ventricle into the left atrium.
What causes mitral valve regurgitation? - The causes of primary mitral regurgitation include myxomatous degeneration of the mitral valve, ischemic heart disease, coronary artery disease.
What're the symptoms of mitral regurgitation? - The symptoms associated with mitral regurgitation are dependent on which phase of the disease process the individual is in.
What're the complications of mitral regurgitation? - Complications of mitral regurgitation include congestive heart failure, atrial fibrillation, blood clot, endocarditis.
How is mitral regurgitation diagnosed? - The diagnosis of mitral regurgitation usually employs imaging studies such as echocardiography or magnetic resonance angiography of the heart.
What're the treatments for mitral regurgitation? - The treatment of mitral regurgitation depends on the acuteness of the disease and whether there are associated signs of hemodynamic compromise.
What is mitral valve stenosis? - Mitral valve stenosis is a narrowing of the opening of the mitral valve in the heart. Stenosis of the mitral valve prevents the valve from opening normally.
What causes mitral stenosis? - Mitral stenosis is often caused by having had rheumatic fever. Rheumatic fever can cause an infection in the mitral valve.
What are the symptoms of mitral stenosis? - Symptoms of mitral stenosis include shortness of breath, fainting, dizziness or tiredness, chest pains (angina), chest infections.
How is mitral valve stenosis diagnosed? - Mitral valve stenosis is usually detected by a physician listening to heart sounds. The diagnosis of mitral stenosis is most easily made by echocardiography.
What're the treatments for mitral stenosis? - The treatment options for mitral stenosis include medical management, surgical replacement of the valve, and percutaneous balloon valvuloplasty.
Mitral valve repair and replacement - Mitral valve replacement surgery is open-heart surgery that is done while the patient is under general anesthesia. |
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