Mitral Stenosis: Causes, Symptoms, Treatment and Cost

Mitral stenosis is a condition in which the mitral valve narrows between the left atrium and the left ventricle of the heart. The blood supply from the left atrium to the left ventricle is restricted or prevented by this restriction.

There are two forms of mitral stenosis (MS): Primary and Secondary.

• Primary Mitral Stenosis: Primary MS is caused by a thickening or narrowing of the leaflets of the mitral valve due to calcium deposits or scarring. This type usually develops slowly over time, although it can also occur suddenly in some cases. It is most commonly seen in people who are older than 50 years old.
• Secondary Mitral Stenosis: Secondary MS occurs when another condition causes damage to the mitral valve, resulting in its narrowing or leakage.

• Mitral stenosis is characterised by a narrowing or stiffening of the mitral valve, which is located between the left atrium and the left ventricle of the heart.
• The narrowing can be due to
• Rheumatic fever, calcification (hardening) of the valve leaflets, or congenital abnormality of the valve are all possible complications of this condition.
• Other causes include
• Radiation therapy to the chest, infective endocarditis
• Systemic lupus erythematosus
• Certain tumours such as carcinoid tumours or certain sarcomas.

The following are the most prevalent Mitral Stenosis symptoms:

• Shortness of breath, particularly while resting down or engaging in strenuous activity
• Palpitations (a sensation of irregular or skipped heartbeats)
• Fatigue
• Swelling in the feet and legs (edema)
• Coughing up blood (hemoptysis)
• Chest pain or tightness (angina)

The following are examples of preventative measures that may be taken to reduce the likelihood of developing mitral stenosis:

• Maintaining a healthy lifestyle,
• Controlling high blood pressure and cholesterol levels
• Avoiding smoking and alcohol consumption,
• And receiving regular medical check-ups to monitor one's cardiac health

The most common tests used to diagnose mitral stenosis includes:

• Echo: In an echocardiogram, sound waves are used to make pictures of the heart, which then allow medical professionals to evaluate the organ's anatomy and function.
• Cardiac catheterization: It is an invasive procedure used to measure pressure within the heart chambers and detect any narrowing or blockages in the valves or arteries supplying blood to the heart.
• Doppler ultrasound: In these studies use sound waves to monitor blood flow through the mitral valve and determine if it is being obstructed by any abnormalities.

• Complications of mitral stenosis can include
• Pulmonary edema,
• Atrial fibrillation,
• Stroke,
• Heart failure.

In addition, patients with mitral stenosis may be at increased risk for infective endocarditis and thromboembolism due to turbulence in blood flow caused by the narrowed valve.

Home remedies that may be helpful:

• Ginger: Ginger has anti-inflammatory properties and may assist in reducing the discomfort felt by the heart. Tea may be made from it, or it can be used in food preparation as a spice.
• Turmeric: The spice turmeric has been shown to have anti-inflammatory effects. Tea may be made from it, or it can be used as a spice in food preparation.
• Shankhapushpi: This Ayurvedic herb is said to have a calming effect on the mind and body. It is frequently consumed in the form of tea or extract.
• Ashwagandha: This Ayurvedic herb is said to provide a variety of health advantages, including stress relief and improved cardiovascular health. It is available as a pill or as an extract.

People who have mitral stenosis really need to eat a diet that is well-rounded and healthy. This comprises the following actions:

• Fruits and vegetables, as well as lean meats and grains in their entire form, are all excellent suppliers of various nutrients.
• Milk with a relatively low amount of fat

• Foods high in sodium and cholesterol should be avoided in cases of Mitral Stenosis.
• Other food includes processed foods, fried foods, fast food, and canned soups.
• Additionally, high-fat dairy products should be avoided.
• Red meat, such as beef and pork, should also be limited.
• Desserts and sweetened beverages with added sugar should also be minimalized.

Lifestyle changes: It include avoiding activities that can lead to an increased heart rate or strain on the heart, such as exercising or lifting heavy objects. It is also critical to have a nutritious diet comprised of fruits and vegetables and limited in salt, saturated fats, and cholesterol.

• Medications: They are used to treat mitral stenosis include diuretics (water pills) which help reduce fluid buildup in the lungs; beta-blockers which help reduce strain on the heart; anticoagulants which help to prevent blood clots; calcium channel blockers which help lower blood pressure; ACE inhibitors which help improve blood flow through the heart; and nitrates which help relax blood vessels.
• Open mitral commissurotomy: This procedure is performed to cut or resect the thickened, fused leaflets of the mitral valve. This technique can be performed as a traditional open-heart surgery or as a minimally invasive robotic-assisted method.
• Mitral valve replacement: The diseased mitral valve is removed and substituted with an artificial valve composed of animal tissue (bioprosthetic) or metal (mechanical) during this treatment.
• Percutaneous balloon valvuloplasty: This is a minimally invasive procedure in which a small balloon catheter is inserted through a vein in the groin and threaded up to the heart where it is used to dilate the narrowed mitral valve opening.
• Transcatheter MitraClip Implantation: This procedure involves inserting a tiny clip that's connected to an implantable device onto the leaflets of the mitral valve using catheters that are inserted through veins in your leg. The clip helps keep your valves from leaking by bringing them together more securely and reducing their size.

For treatment of this issue, a consultation with a cardiologist is recommended.

In order to diagnose your condition and figure out how best to treat it, your doctor will first conduct a physical exam on you, during which he or she will listen to your heart using a stethoscope.

The best medicines include:

• Beta-blockers: These medications reduce your heart rate, making it easier for your heart to pump blood through the narrowed valve. Atenolol(Tenormin),Bisoprolol (Zebeta),Metoprolol (Lopressor, Toprol XL)are some examples of this class.
• ACE Inhibitors: These medications relax blood arteries, allowing your heart to flow blood more easily through the constricted valve. Benazepril (Lotensin), Captopril (Capoten), Enalapril (Vasotec),Fosinopril (Monopril) are some common medicines of this class.
• Diuretics: Also known as water pills, these medications help remove extra fluid from your body, which can reduce pressure on the narrowed valve and improve symptoms. Chlorothiazide (Diuril), Hydrochlorothiazide (Microzide), lndapamide (Lozol) are some common example of this class.
• Warfarin or other anticoagulants: These medications are used to prevent blood clots from forming in the narrowed valve and blocking blood flow in your heart.

The time it takes to recover from mitral stenosis depends on the severity and kind of treatment used.

Generally, it may take several weeks to months to fully recover from surgery, and up to a year for the heart valves to become fully functional after balloon valvuloplasty.

Treatment for mitral stenosis often does not result in lasting improvement of the condition. The treatment's objectives are to alleviate patients' symptoms, halt further illness development, and enhance their quality of life.

While these treatments can help reduce symptoms and slow progression, they do not cure mitral stenosis and lifestyle modifications are still needed to manage it effectively over time.

If you have undergone surgery for mitral stenosis, it is important to follow the instructions of your healthcare team to ensure a successful recovery. This may include:

• Getting enough of rest and avoiding activities that are physically taxing might help.
• Always keep a tight watch on your blood pressure as well as your heart rate, and do this on a regular basis.
• If you suffer any odd symptoms, such as chest discomfort or trouble breathing, you should get medical treatment as soon as possible.

• The cost of Mitral Stenosis therapy in India varies according to the severity of the ailment and the type of treatment selected.
• Conservative treatments such as medications and lifestyle changes are generally less expensive than more invasive treatments like surgery or balloon valvuloplasty.
• Depending on the method of treatment that is selected, the total cost of care might range anywhere from a few thousand rupees to many lakhs of rupees.

The most common side effects of mitral stenosis treatments are

• Drowsiness, abnormal heart rhythms, and a drop in blood pressure are all symptoms of low blood pressure.
• Discomfort in the chest
• Major adverse effects include the following:
• Swelling in the feet or ankles,
• Nausea or vomiting, and difficulty breathing.

If you are suffering from any complications relating to mitral stenosis then you should consult a doctor nearby as they can cause complications like ' pulmonary edema, atrial fibrillation, stroke, and heart failure' in which treatment course can range from a few months to years depending on the severity of the situation.