Mitral Stenosis

Question: are mitral regurgitation and mitral stenosis the same thing? I have just been told i have angina and my doctor has given me a spray to use during an attack. It says on the leaflet not to use if you have mitral stenosis disease, i have mitral regurgitation. I am not sure if i should call my doctor again to double check that i can take it.

Answer: No they are not exactly the same. "Mitral regurg" is the name given to blood flow that leaks and flows in the reverse direction through the mitral valve inside the heart. When the valve closes properly, there should be little or no reverse flow. During a colour doppler ultrasound exam, blood flow in the heart is represented as blue and red depending on the direction of blood flow. Mitral regurg will show as a burst of reverse colour. Mitral stenosis is a blockage at the valve that prevents it from closing properly. Mitral stenosis could cause mitral regurg. I would ask your doctor if the nitro spray is a concern. My guess is, it is not a concern because the nitro spray is used to dialate the arteries in the body, ( especially the coronaries ) to allow good blood flow to the heart muscle.

Question: Is inderal pills and pencillin injection a better treatment for mild mitral stenosis? I have Mild MS by calcification, do i definitely need a surgery in future? Will it be a replacement or repair?

Answer: Surgery is reserved for severe mitral stenosis with a significantly decreased ejection fraction. Depending on the type/severity you could have a mechanical valve replacement or a valve repair. I believe the inderal and penicillin are prophylactics against bacterial endocarditis, or when an infection lodges on the stenotic valve because of fluid dynamic changes.

Question: why in mitral stenosis, does a patient lay on his left side during auscultation ? what is the mechanism by which laying on his left side accentuate the sound?

Answer: Hello, I agree, the mitral valve is inside the left side of the heart. When you turn onto your left side, the heart tends to fall by gravity against the inside of the chest wall. Hence a murmur from this valve, (either 'mitral stenosis' or 'mitral incompetence,') will often sound louder and thus easier-to-hear. Another trick to make mitral valve murmurs easier to hear, is to get your lying-down patient to sit up-and-down vigorously a few times. This increases their heart rate and the blood-flow through the mitral valve, hence "turbulence" noises get louder. I hope this is of some help. Belliger (retired uk GP)

Question: There can be a systolic murmur even in mitral stenosis without regurgitation in the mitral area. How? Read this in Harrison's Principles of Internal Medicine. I read this in the Harrison's Principles of Internal Medicine.

Answer: Ketan P, an intersting Q. here. Are you asking us to read it in Harrison's or did you read this problem in Harrison's? May be it has something to do with Semilunar Valves of the Aorta at the time of Systole? Anyhow, would be glad to know the answer right here without needing to open the heavyweight.. ;-)

Question: I am diagnosed with a mitral valve stenosis, and I need a valve replacement thru open heart surgery.? Does anybody here have similar condition?

Answer: Mitral stenosis is narrowing of the valve between the left atrium (upper chamber) and the left ventricle (lower chamber). The requirement for surgery can be decided only after detailed assessment including an echocardiogram. Only if the valve narrowing is severe and the valve is embedded with calcium will you need valve replacement through open heart surgery. Mild - moderate narrowing may only need medical follow up. Even with severe narrowing, it is possible to enlarge the narrowed valve using balloon, without open heart surgery, under x-ray fluroscopic guidance. This is known as balloon mitral valvotomy.

Question: What is severe subpulmonary stenosis due to mitral valve chordal apparatus with a peak gradient of 72 mmHg? My son is 9 months old and was born with a rare heart defect cctga. He was diagnoised 2 months ago and at his echo they wrote that on the results. I am going to ask when I go down in a month but I have noticed there are a few dr's. on here so I was hoping someone would have some insight. What does this mean and what questions should I be asking his card? thank you

Answer: CCTGA means congenitally corrected transposition of great arteries. In usual transposition aorta which should carry oxygenated blood gets connected to right ventricle and pulmonary artery which should be carrying deoxygenated blood to lungs gets connected to left ventricle. In congenitally corrected transposition, in addition to this, right atrium (upper chamber) connects to the left ventricle and left atrium connects to the right ventricle. So there is a double reversal which becomes near normal. This is because deoxygenated blood from right atrium goes to left ventricle and then through pulmonary artery, into the lungs for oxygenation. Similarly, oxygenated blood from left atrium goes to right ventricle and to the aorta, into the general circulation. So everything is fine till this as this is near normal functioning of the heart. The addtional problem which your son is that he has a narrowing below the pulmonary valve, which may require correction at a suitable time, which only the treating doctor can tell you. The narrowing is due to the structures attached to the mitral valve (chordal apparatus) in the left ventricle, the ventricle which is connected to the pulmonary artery in his case. In a normal individual, left ventricle connects to the aorta and not the pulmonary artery.

Question: what are the important steps that a person with mild mitral valve stenosis should take in his life? or to avoid surgery condition and live a normal life??

Answer: You probably know in advance everything I'm going to say! Good evaluation and treatment by an experienced cardiologist is at the top of the list. Taking your medications exactly as prescribed is number two. Be sure the doc knows the supplements you take, if any, as some aren't compatible with prescriptions (for instance, be sure your MD knows if you take fish oil or garlic AND an anticoagulant or aspirin). Good exercise, especially daily walking, will make an incredible difference. (Get yourself a dog!) For many people, the more you walk, the longer you live. Eat all the vegetables and fruits you can get into yourself. See if your hospital or clinic has a good dietician who knows about heart disease.Could you stand being a vegetarian? It might make a difference. Manage stress and blood pressure. Don't take baths that are too hot. Stay hydrated when the weather is hot, don't shovel snow, get yourself an electric blanket and warm up your bed at night when it's cold, so that your feet and legs will be warm, and you'll minimize the chances of late night leg cramps. TURN OFF this blanket before you actually get into the bed to sleep, so that the blanket is not "on" with you in it (just in case there's something to the rumor that the electric fields so close to your body might constitute a cancer risk.). Don't smoke, get good advice about whether a glass of wine a day would be a good treatment option. Get a copy of your EKG; photocopy as much as you can of the tracing down to wallet size (in other words, tiny!); write on the back of this tracing all your medications, your blood type, the name and phone number of your doctor, and who to contact if you're unconscious. Wrap this around your health care or insurance card, or clip them together. Keep this in your wallet. If you're ever unconscious, you'll have some vital medical info immediately available to your first care providers.

Question: I have mitral valve regurgitation and stenosis. Is this the cause of my night sweats ? should i write my will ?

Answer: Probably not unless you have an active inflammation or infection in your mitral valve. Look for another cause. Everyone should have a will.

Question: Mitral stenosis question - Please help me.? Discuss the signs and symptoms of mitral stenosis, explaining how each of these results from the basic structural abnormality? can anyone help me on the above question..i have a list of symptoms i.e fatigue, shortness of breath, edema - swollen feet and ankles..but unable to explain how this results from the basic structural abnormality.. please help... Thanku..x

Answer: Wow, you need a doctor. There's not enough info about your age, your location, etc etc. Mitral stenosis, causes left atrial dilatation because the narrow valve stops or slows the blood flow into the left ventricle....this leads to build up of pressure in the pulmonary system....the left atrium dilates, atrial fibrillation occurs because the dilated muscle stretches the "wiring " of the heart and it beats irregularly....all of this causes congestion, increased pressure, and finally, fluid seeps out of the blood vessels in the lungs causing pulmonary oedema, .......etc etc. That is precisely why your doctor needed to study for 7 years at least....and longer. go see your doctor, , the physiology of even a simple muscle like the heart is endlessly complex and fascinating, the elsctro physiology is amazing. Yes , it is only a muscle, but in microscopic, electro physiological and evolutionary sense it is state of art machinery.

Question: Mitral stenosis : Balooning done 14 yrs back : Two questions.? Hi All My mother had balooning done for Mitral stenosis 14 yr back. We do her ECHOCHARDIOGRAPHY time to time and the opening has decreased as compared to when the surgery was done. Question : 1. What should be the next step to cure it. (Another Balooning or something else ? ) 2. Is Air Travel advisable for her. 14 hrs of flight from Asia(India) to USA.

Answer: Valvuloplasty. This procedure is less likely to work in patients with severely damaged mitral valves. To determine which patients would benefit from percutaneous balloon mitral valvuloplasty, a scoring system has been developed. Scoring is based on echocardiographic criteria: leaflet mobility, leaflet thickening, subvalvar thickening, and calcification. Individuals with a score of ≥ 8 tended to have suboptimal results. Superb results with valvotomy are seen in individuals with a crisp opening snap, score < 8, and no calcium in the commissures.The indication for invasive treatment with either a mitral valve replacement or valvuloplasty is based on NYHA functional class III or IV symptoms. Valve replacement is a last resort but is indicated for patients with a mitral valve area ≤ 1.5 cm2, moderate to severe symptoms, and valvular pathology (eg, fibrotic cusps) that precludes use of other procedures. Consult your cardiologist. Please see the web pages for more details on Mitral stenosis, Mitral valve replacement and NYHA Functional classification

Question: What would life expectancy be with Mitral Stenosis? My mother has Mitral Stenosis, her heart was damaged by Rheumatic Fever as a child. Surgery is out of the question, there are no medicines that will help her, in her case. She has a pace-maker and defibulator, I need to know what to expect and I would like to know how much time she may have left. I know that noone knows how long anyone has to live. I dont feel like she has told me everything her Dr. has told her, I would really like to know or have an idea of what to expect ? please help !

Answer: There is an awful lot of information out there....too much to condense here...But, I did a quick search on "Mitral Stenosis non-operative" and I would suggest you look at the following articles (over 9000) for a more comprehensive understanding....(sorry I couldn't narrow it down more....) http://circ.ahajournals.org/cgi/search?j… So sorry for you and your mom! Wish you all the best...

Question: Stenosis of the of the mitral valve may initially cause a pressure increase in the:? Venae cavae left ventricle Pulmonary circulation Coronary circulation *I am not sure what one is the correct answer but I know that narrowing of the mitral valve affects the left side of the heart so I thought it was the left ventricle, but I am still not sure please help.

Answer: Without looking it up, so I may be wrong here.... The mitral valve allows for the passage of oxygenated blood from the left atrium into the left ventricle. The purpose of a valve is to allow for passage of blood in the correct direction without regurgitation. Stenosis is a stiffening, so the flow of blood would be impeded. There may be backup into the left atrium, increasing pressure to the left atrium, further placing an increased workload on the left atrium. There would be a cascade of pressure buildup to the lungs, and therefore pulmonary circulation, maybe leading to pulmonary edema. Due to Pulmonary edema, there may then also be a cascade effect to the right ventricle. The human body is a very complex and intricate piece of work. Going by your choices.... Vena cavea is the major vein returning de-oxygenated blood to the heart (right atrium), so I would eliminate taht answer. Left ventricle returns oxygenated blood to the body VIA the aorta, the major artery. As the mitral valve affects the left side of the heart, and a mitral valve stenosis would allow for regurg, the left ventricle would need to work harder to pump blood to the body, and it may increase pressure. This is a good choice. Pulmonary circulation has inflow of de-oxygenated blood VIA the right ventricle and pulmonary arteries, and oxygenated blood through the pulmonary vein to the left atrium. This pressure may be increased due to the stenosis. I would think that this answer is better than the previous one. Coronary circulation branches off the ascending aorta, and may also be affected, but I would think to a lesser extent. This is an OK choice, but not as good as the previous two choice. Again, without looking it up, I would be somewhat torn between the left ventricle and pulmonary circulation, leaning towards pulmonary circulation. I look forward to seeing other people's answers, and I may look this one up... OK - the above answer was entered a couple of hours ago, and since I have conferred with a colleague, and he concurs that the pulmonary circulation would be affected initially.

Question: reversal of atrial fibrillation to sinus rhythm in a csae of cerebrovascular stroke and mitral stenosis?

Answer: Cardioversion/Defibrillation. Everybody clear! That is the only thing that I can think of, besides the medication adenosine. Something, or someone has to reset the av node. But you know, now that I think about it, it could be a faulty mitral valve that caused the "a fib" in the first place. You should really speak to a cardiologist. *Update A pacemaker may also be a permanent means by which to control "A-fib" without meds. And speaking of meds, doctors don't like to use amiodarone because it is extremely toxic. Be careful stimulating those vagal receptors by coughing real hard, bearing down and such. It can cure "a fib" with a more potentially fatal heart rhythm called asystole. But don't take our word for it, I implore you to speak with a physician.

Question: My son has been treated for Aortic Stenosis he also has a mitral valve in parachute. Is the operation serious? My son has been treated for Aortic Stenosis when he was a baby, he also has a mitral valve in parachute. Is the operation dangerous? Is the survival rate high? What are his expectations of living a "normal" life? Is is his life expectancy normal (will he reach a common old age?)

Answer: I am sorry to read your son's condition, I have searched out this link and you will get an insight view: http://www.emedicine.com/ped/topic2178.h…

Question: Does anybody know any group for Mitral Stenosis patients?

Answer: No, but check this site. www.glyconutrientsreference.com

Question: My friend's father is sufffering from Mitral Stenosis.Need help.? Dear all, I had to ask about any site or donor you know to provide financial help for operation of Mitral Stenosis ( MRV- Mitral Valve Replacement ) His financial condition is very weak. Patient has to under operation on 11.09.2007 . I need your help. It's urgent. Thanks in advance Waiting for your valuable reply.

Answer: What Happens During Traditional Heart Valve Surgery? During traditional heart valve surgery, a surgeon will make an incision down the center of your sternum (breastbone) to get direct access to your heart. Often, the surgeon and cardiologist (heart doctor) will use a probe that is passed down the esophagus to help determine the functioning of the valve before and after surgery. If your valve can be repaired, your surgeon will perform any of the following types of valve repair procedures. 1.Commissurotomy. Fused valve leaflets are separated to widen the valve opening. 2.Decalcification. Calcium deposits are removed to allow the leaflets to be more flexible and close properly. 3.Reshape leaflets. If one of the leaflets is floppy, and bows back into the left atrium, a segment may be cut out and the leaflet sewed back together, allowing the valve to close more tightly. 4.Repair of chordae or papillary muscles. If the chordae or papillary muscles are torn or stretched out, they will not give the valve leaflets support. The surgeon may transfer or shorten the chordae to the correct length to provide support for the leaflet, allowing the valve to seal tightly. 5.Annulus support. If the valve annulus (the ring of tissue supporting the valve) is too wide, it may be reshaped or tightened by stitches or sewing a ring structure to the annulus. The ring may be made of tissue or synthetic material. 6.Patched leaflets. The surgeon may patch any leaflets with tears or holes with tissue patches.