Mitral Stenosis Treatment in Singapore

What is Mitral Stenosis?

Mitral stenosis occurs when the opening of the mitral valve becomes narrowed, making it harder for blood to flow from the left atrium into the left ventricle. The mitral valve is located between these two chambers of the heart.

Rheumatic heart disease is a major cause of mitral stenosis worldwide. In older adults, narrowing may also occur because of calcium deposits around the mitral valve. Other causes include congenital valve abnormalities and, less commonly, other conditions affecting the heart valves.

As the narrowing progresses, pressure can build up in the left atrium and the blood vessels supplying the lungs. Severe mitral stenosis may lead to pulmonary hypertension (high blood pressure in the lungs' blood vessels), atrial fibrillation (an irregular heart rhythm), blood clots, and heart failure.

What is the Importance of Timely Treatment?

Timely treatment can help relieve breathlessness and other symptoms, reduce pressure on the heart and lungs, manage complications such as atrial fibrillation, and prevent worsening heart failure. Regular assessment also helps determine whether monitoring, medicines, percutaneous mitral balloon commissurotomy, or surgery may be appropriate based on valve anatomy and disease severity.

What are the Common Symptoms of Mitral Stenosis?

• Shortness of Breath: Breathlessness may occur during physical activity and can become more noticeable as the valve narrowing progresses.
• Fatigue: Reduced blood flow into the left ventricle may contribute to tiredness and reduced physical endurance.
• Palpitations: An irregular or rapid heartbeat may occur, particularly when atrial fibrillation develops.
• Reduced Exercise Tolerance: Routine activities may become increasingly difficult because of breathlessness or fatigue.
• Swelling: Fluid retention may cause swelling of the ankles, feet, or lower legs, particularly in more advanced disease.
• Dizziness or Chest Discomfort: Some patients may experience lightheadedness or chest discomfort, especially during exertion.

Causes and Risk Factors of Mitral Stenosis

Causes

• Rheumatic Heart Disease: Previous rheumatic fever can cause progressive scarring and narrowing of the mitral valve and remains the most common cause worldwide.
• Mitral Valve Calcification: Calcium deposits can progressively restrict valve movement, particularly in older adults.
• Congenital Mitral Stenosis: Some people are born with mitral valve abnormalities that cause narrowing.
• Autoimmune or Inflammatory Conditions: Conditions such as lupus can rarely contribute to mitral valve disease.
• Other Structural Valve Changes: Less common abnormalities may also interfere with normal mitral valve opening.

Risk Factors

• Previous rheumatic fever or rheumatic heart disease
• Increasing age
• History of valvular heart disease
• Congenital heart abnormalities
• Conditions associated with valve calcification
• Certain autoimmune or inflammatory diseases
• Previous heart-valve procedures

Latest Research and Technologies in the Treatment of Mitral Stenosis in Singapore

• Advances in cardiac imaging and treatment planning help doctors assess mitral valve structure, determine the severity of narrowing, and select appropriate treatment options.
• Depending on the patient's needs and the facilities available, assessment may include transthoracic and transesophageal echocardiography, three-dimensional echocardiography, cardiac CT, and specialised catheter-based evaluation. These techniques can help assess valve anatomy, calcium deposits, blood flow, and suitability for procedures such as percutaneous mitral balloon commissurotomy.