How to Diagnose Mitral Stenosis
Watch for shortness of breath.One of the main symptoms that mitral stenosis may present with is shortness of breath — in particular, waking in the night with breathing difficulties.The shortness of breath may get worse with exertion, and/or when...
Step-by-Step Guide
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Step 1: Watch for shortness of breath.One of the main symptoms that mitral stenosis may present with is shortness of breath — in particular
The shortness of breath is caused by decreased effectiveness of blood flow with each heartbeat, due to partial blockage of the mitral valve (called "stenosis").
Your shortness of breath may progressively get worse with time.
Your exercise tolerance may also decrease with time, as your condition worsens. -
Step 2: waking in the night with breathing difficulties.The shortness of breath may get worse with exertion
Again, this is due to less effective blood circulation, and thus reduced oxygen delivery to your tissues.
Over time, the increased work that your heart must do to pump blood throughout your body can lead to progressively worsening fatigue. , Therefore, the pressure in your left atrium builds up, and can cause a backup of blood in the lungs (because blood flows directly from the lungs into the left atrium).
As a result, mitral stenosis may cause fluid build-up in your lungs.
It can also cause a cough that may or may not be accompanied by coughing up small amounts of blood. , If you feel this way, it is important to sit or lie down until you feel better, to avoid passing out while standing and injuring yourself.
It is also important to tell your doctor as it may be a sign of mitral stenosis or another medical condition, and it merits proper medical investigation. , This is a symptom of right heart failure, which may occur as a result of mitral stenosis.
It occurs due to the backup of blood that cannot be effectively pumped through the heart. , Either way, it feels like your heart is behaving abnormally.
It is important to tell your doctor about this as it may be a sign of mitral stenosis, or of another heart condition that warrants medical attention and investigation. , One of the major risk factors for mitral stenosis in developing countries is a history of rheumatic fever (which can damage and scar the mitral valve).
This is less common in developed countries due to more effective modes of treatment that can prevent the development of rheumatic fever.
Other risk factors include calcium deposits around your mitral valve, chest radiation, certain medications, a family history of mitral stenosis, or having congenital birth defects involving the heart. , Although this is not enough to diagnose mitral stenosis, it is suspicious of a heart problem and would be an indication for your doctor to order further investigative tests. , A chest x-ray allows your doctor to examine your lungs for fluid build-up (called "pulmonary edema") which may go hand-in-hand with mitral stenosis.
Your doctor can also evaluate for enlargement of any of the chambers of your heart, such as the right atrium, which may also be a sign of mitral stenosis.
A chest x-ray is also useful in ruling in or ruling out other heart or lung conditions that may present similarly to mitral stenosis.
It is for this reason that it is normally one of the first investigative tests that is ordered. , An ECG is able to detect the amount of "stress" on the heart in various situations. , The first type performed will normally be a TTE (transthoracic echocardiogram).
In a TTE, the ultrasound probe is placed on the outside of your chest.
It then projects a real-time, colored, moving image of the heart on a screen, where the doctor can look at the structure of your heart as well as the flow of blood with each heartbeat.
The color in the TTE can help indicate the flow of blood.
A TTE may be sufficient to observe and confirm the diagnosis of mitral stenosis.
If it is not, a TEE (transesophageal echocardiogram) may be ordered.
In a TEE, rather than the ultrasound probe being placed on the outside of your chest, it is inserted into your esophagus.
Your esophagus is much closer to your heart anatomically, so a TEE can provide a much more detailed view than a TTE, which can aid in the diagnosis of mitral stenosis. , Most cases can be controlled in the interim with medications; however, most cases will eventually require surgery once the condition gets to be severe enough.
Doctors call this approach "watchful waiting." You are advised to receive regular echocardiograms to monitor your mitral stenosis, and to see if and when your condition progresses to the point of potentially needing surgery.
The frequency of your echocardiogram examinations will depend upon the severity of your mitral stenosis. , Some medications that you and your doctor may wish to discuss include:
Blood thinning medications such as Warfarin (coumadin), plus or minus aspirin, to prevent blood clot formation and thus reduce your risk of a stroke.
Medications such as Beta-blockers (e.g.
Metoprolol) to decrease your heart rate and thus allow the chambers of your heart to fill with blood more effectively.
A water pill (called a "diuretic"), such as hydrochlorothiazide or furosemide, to decrease the swelling in your lower extremities. , Your doctor can go over the pros and cons of each surgical option with you if and when it comes time for you to receive surgery — there are minimally invasive surgical options to consider for some patients. -
Step 3: and/or when lying down.
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Step 4: Watch for any unusual fatigue.In addition to shortness of breath
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Step 5: mitral stenosis often presents with fatigue beyond your normal level.
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Step 6: Look out for a cough and possible blood in your sputum.Mitral stenosis makes it more challenging for blood to pass from your left atrium into your left ventricle.
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Step 7: Take note if you are feeling episodes of dizziness or fainting.Due to the reduced effectiveness of circulating blood and oxygen distribution to key areas of your body (such as your brain)
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Step 8: you may begin to feel dizzy
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Step 9: lightheaded
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Step 10: or faint if you have mitral stenosis.
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Step 11: Observe for swelling in your lower extremities.You may begin to notice swollen feet
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Step 12: ankles
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Step 13: and/or legs if you have mitral stenosis.
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Step 14: Tell your doctor if you are experiencing heart "palpitations" (unusual heartbeats).Heart palpitations may feel like unusually forceful heartbeats
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Step 15: or you may have the sensation of your heart "fluttering" in your chest.
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Step 16: Consider your risk factors.To diagnose mitral stenosis
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Step 17: your doctor will ask you about predisposing risk factors.
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Step 18: Have your doctor listen for a heart murmur with a stethoscope.Mitral stenosis often presents with a heart murmur that can be heard when your doctor listens with his or her stethoscope.
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Step 19: Get a chest x-ray.A chest x-ray is normally one of the first tests your doctor will order
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Step 20: if he or she suspects a lung and/or a heart problem
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Step 21: such as mitral stenosis.
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Step 22: Consider an ECG (electrocardiogram).In the evaluation of heart or lung problems such as mitral stenosis
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Step 23: an ECG (sometimes accompanied by an exercise stress test) can be helpful.
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Step 24: Receive an echocardiogram to definitively diagnose mitral stenosis.In order to confirm the diagnosis of mitral stenosis (or of any other form of valvular heart disease)
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Step 25: an echocardiogram is needed.
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Step 26: Be aware that treatment for mitral stenosis may not be needed immediately.In many cases of mitral stenosis
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Step 27: surgery is needed eventually but not immediately.
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Step 28: Opt for medical treatment to reduce your symptoms.Although medications cannot treat or cure mitral stenosis directly
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Step 29: they can help to ease symptoms and to improve your overall heart and lung function.
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Step 30: Consider valve repair or valve replacement surgery.The only definitive treatment for mitral stenosis is to have the valve surgically repaired or replaced.
Detailed Guide
The shortness of breath is caused by decreased effectiveness of blood flow with each heartbeat, due to partial blockage of the mitral valve (called "stenosis").
Your shortness of breath may progressively get worse with time.
Your exercise tolerance may also decrease with time, as your condition worsens.
Again, this is due to less effective blood circulation, and thus reduced oxygen delivery to your tissues.
Over time, the increased work that your heart must do to pump blood throughout your body can lead to progressively worsening fatigue. , Therefore, the pressure in your left atrium builds up, and can cause a backup of blood in the lungs (because blood flows directly from the lungs into the left atrium).
As a result, mitral stenosis may cause fluid build-up in your lungs.
It can also cause a cough that may or may not be accompanied by coughing up small amounts of blood. , If you feel this way, it is important to sit or lie down until you feel better, to avoid passing out while standing and injuring yourself.
It is also important to tell your doctor as it may be a sign of mitral stenosis or another medical condition, and it merits proper medical investigation. , This is a symptom of right heart failure, which may occur as a result of mitral stenosis.
It occurs due to the backup of blood that cannot be effectively pumped through the heart. , Either way, it feels like your heart is behaving abnormally.
It is important to tell your doctor about this as it may be a sign of mitral stenosis, or of another heart condition that warrants medical attention and investigation. , One of the major risk factors for mitral stenosis in developing countries is a history of rheumatic fever (which can damage and scar the mitral valve).
This is less common in developed countries due to more effective modes of treatment that can prevent the development of rheumatic fever.
Other risk factors include calcium deposits around your mitral valve, chest radiation, certain medications, a family history of mitral stenosis, or having congenital birth defects involving the heart. , Although this is not enough to diagnose mitral stenosis, it is suspicious of a heart problem and would be an indication for your doctor to order further investigative tests. , A chest x-ray allows your doctor to examine your lungs for fluid build-up (called "pulmonary edema") which may go hand-in-hand with mitral stenosis.
Your doctor can also evaluate for enlargement of any of the chambers of your heart, such as the right atrium, which may also be a sign of mitral stenosis.
A chest x-ray is also useful in ruling in or ruling out other heart or lung conditions that may present similarly to mitral stenosis.
It is for this reason that it is normally one of the first investigative tests that is ordered. , An ECG is able to detect the amount of "stress" on the heart in various situations. , The first type performed will normally be a TTE (transthoracic echocardiogram).
In a TTE, the ultrasound probe is placed on the outside of your chest.
It then projects a real-time, colored, moving image of the heart on a screen, where the doctor can look at the structure of your heart as well as the flow of blood with each heartbeat.
The color in the TTE can help indicate the flow of blood.
A TTE may be sufficient to observe and confirm the diagnosis of mitral stenosis.
If it is not, a TEE (transesophageal echocardiogram) may be ordered.
In a TEE, rather than the ultrasound probe being placed on the outside of your chest, it is inserted into your esophagus.
Your esophagus is much closer to your heart anatomically, so a TEE can provide a much more detailed view than a TTE, which can aid in the diagnosis of mitral stenosis. , Most cases can be controlled in the interim with medications; however, most cases will eventually require surgery once the condition gets to be severe enough.
Doctors call this approach "watchful waiting." You are advised to receive regular echocardiograms to monitor your mitral stenosis, and to see if and when your condition progresses to the point of potentially needing surgery.
The frequency of your echocardiogram examinations will depend upon the severity of your mitral stenosis. , Some medications that you and your doctor may wish to discuss include:
Blood thinning medications such as Warfarin (coumadin), plus or minus aspirin, to prevent blood clot formation and thus reduce your risk of a stroke.
Medications such as Beta-blockers (e.g.
Metoprolol) to decrease your heart rate and thus allow the chambers of your heart to fill with blood more effectively.
A water pill (called a "diuretic"), such as hydrochlorothiazide or furosemide, to decrease the swelling in your lower extremities. , Your doctor can go over the pros and cons of each surgical option with you if and when it comes time for you to receive surgery — there are minimally invasive surgical options to consider for some patients.
About the Author
Cheryl Russell
Enthusiastic about teaching pet care techniques through clear, step-by-step guides.
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