Causes of Mitral Valve Stenosis

Mitral valve stenosis occurs when the mitral valve of the heart is narrowed. This means that the valve cannot open properly, impeding blood flow from the lungs to the rest of the body. 

There are several known causes of mitral valve stenosis, including rheumatic fever and congenital heart defects.

Risk Factors

Risk factors for developing mitral valve stenosis include rheumatic fever and radiation treatments. Having a risk factor does not mean that you will develop mitral valve stenosis. 

Rheumatic Fever: At one time, this was the most common cause of mitral valve stenosis. In the United States, rheumatic fever is now quite rare. 
Radiation: Radiation treatment near the chest has been shown to increase the risk of developing mitral valve stenosis.


Symptoms of mitral valve stenosis may not be immediately apparent. Usually symptoms of mitral valve stenosis appear in patients between the ages of 40 and 50. However, mild symptoms may quickly worsen, so you should call your doctor if you are experiencing one or more of the following symptoms. Having one or more of these symptoms does not mean that you have mitral valve stenosis.

  • Fatigue, especially during increased physical activity
  • Shortness of breath, especially during increased physical activity or when lying flat
  • Swelling of the feet or ankles
  • Heart palpitations or a rapid, fluttering heartbeat
  • Frequent respiratory infections
  • Heavy coughing, especially if blood is present

Diagnostic Tests

If you are experiencing any signs and symptoms of mitral valve stenosis, our cardiac surgeons may recommend one or more of the following tests to check for the condition:

Echocardiogram: An echocardiogram uses sound waves to create an image of the heart. Our surgeons can examine the image of the heart and the mitral valve to determine the cause of the mitral valve stenosis and if it requires replacement.

Transthoracic echocardiogram (TTE): This is the most common way of performing an echocardiogram where images of the heart are obtained through the chest wall.

Transesophageal echocardiogram (TEE): With this type of echocardiogram, a probe is passed down the esophagus. It is more invasive, requiring sedation, but allows for an even clearer image of the heart than transthoracic echocardiograms. TEE is sometimes required prior to mitral valve  surgery.

Chest X-ray: An X-ray image allows our cardiac surgeons to evaluate the size and shape of the heart. If the left atrium is enlarged, it may indicate mitral valve stenosis. Mitral valve stenosis sometimes causes congestion in the lungs, which is also visible in the X-ray image. 

Electrocardiogram (ECG): An ECG allows our surgeons to evaluate the heart’s rhythm and its size because mitral valve stenosis may cause heart enlargement and irregular rhythms. 

Holter monitoring: A Holter monitor is a portable device that records a continuous ECG designed to detect any heart rhythm irregularities. This monitor is usually worn between 24 and 72 hours. The information gathered from the monitor is reviewed to check for any recorded irregularities.  

Cardiac catheterization: A cardiac catheterization can provide detailed information of the degree of mitral valve stenosis. It will also  detect concomitant coronary artery disease.


In order to treat mitral valve stenosis, our surgeons may sometimes recommend mitral valve repair; however, most often the mitral valve needs to be replaced. Our surgeons are highly experienced at performing mitral valve replacement and repair using minimally invasive techniques.

Valvuloplasty: This is a procedure designed to repair the mitral valve. Our cardiac surgeons are able to  repair the valve such that most or all of the narrowing is relieved.  

Mitral valve replacement: Our surgeons may recommend that your mitral valve be replaced. This is most commonly done with a mechanical or biologic tissue valve.

We understand that the thought of undergoing heart surgery can feel overwhelming. Our surgeons will review your surgical plan with you, in detail, so that you know what to expect before, during, and after your procedure. You can rest assured that you will be cared for by top surgeons internationally renowned for their minimally invasive techniques and innovative treatment strategies.

Make An Appointment

Yale Cardiac Surgery
800 Howard Avenue, 2nd Floor
New Haven, CT 06511

T 203.785.5000
F 203.785.3346

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