Mitral stenosis (mitral valve stenosis) is a condition wherein there is narrowing of the mitral valve opening. This results in increased resistance to blood flow from the left atrium to the left ventricle.

Usually it presents with Atrial fibrillation.

Causes

• Most common cause: Rheumatic fever resulting in Rheumatic Heart Disease.
• Other rare causes:
• Calcification of mitral valve leaflets
• Congenital heart disease 

Symptoms

• MIld stenosis can be comepletely asymptomatic.
• Some of the common symptoms are:
• Dyspnoea(shortness of breath)
• Fatiguability
• Chest discomfort
• Palpitations
• All the above symptoms worsen on exertion. Other symptoms include
• Cough, usually hemoptysis
• Frequent respiratory infections such as bronchitis
• Swelling of lower limbs(feet and ankles) 

Diagnosis

• Diagnosis is made after a Physical examination. Some of the investigations useful are:
• Chest X-ray
• ECG(Electrocardiogram)
• Echocardiogram
• MRI of the heart
• Transesophageal echocardiogram(TEE)
• Cardiac catheterization 

Treatment

Treatment can be either medical or surgical or both.

Medical Management includes use of diuretics, beta blockers or calcium channel blockers. High blood pressure should require correction. Anticoagulants (blood thinners)  like Aspirin are used to prevent blood clots.

If there is no improvement with drug therapy then the valve is repaired or replaced surgically.

Percutaneous mitral balloon valvotomy i.e. valvuloplasty can be considered instead of surgery.

Prognosis

Prognosis is very much variable from person to person. It can be mild without symptoms or can be severe. Symptoms are usually controlled with treatment either medical or surgical.

Complications

• Atrial fibrillation and atrial flutter
• Stroke due to blood clots in the brain.
• Cardiac failure
• Pulmonary edema
• Pulmonary hypertension 

Prevention

Prompt and timely management of rheumatic fever can reduce the incidence significantly.