Rheumatic Heart Disease Mitral Valve Stenosis: Effective Treatment Options

Rheumatic heart disease affecting the mitral valve is a consequence of acute rheumatic fever impacting the heart, ultimately leading to structural changes in the heart valves. Over time, persistent rheumatic inflammation and mechanical stress from abnormal blood flow cause swelling, inflammation, and the development of abnormal growths on the mitral valve. As the condition progresses, healing processes lead to the deposition of platelets and fibrin, causing the valve leaflets to fuse and thicken. This results in a narrowed valve opening, often accompanied by calcification, stiffness, and structural changes to the supporting tendons and muscles.

Understanding the Progression of Mitral Valve Stenosis

Initially, the valve may become inflamed due to recurrent episodes of rheumatic fever. As healing occurs, fibrous tissue replaces normal valve tissue, making the valve less flexible. This progressive stiffening and narrowing of the mitral valve restricts blood flow from the left atrium to the left ventricle, increasing pressure in the atrium and potentially leading to complications such as atrial fibrillation or pulmonary hypertension.

Treatment Approaches for Mitral Valve Stenosis

There are two primary treatment strategies for managing mitral valve stenosis: medical therapy and surgical intervention. Medications are often used to manage symptoms and support heart function. These may include diuretics to reduce fluid buildup, beta-blockers or calcium channel blockers to control heart rate, and anticoagulants to prevent blood clots, especially in patients with atrial fibrillation.

Surgical Treatment Options

When the stenosis becomes more severe or symptoms worsen, surgical treatment is often necessary. The two most common procedures are mitral valve replacement and mitral valve repair. Valve repair, also known as valvuloplasty, aims to widen the narrowed valve and restore normal function. This can be done either through open-heart surgery or via a minimally invasive catheter-based procedure known as balloon mitral valvuloplasty. In cases where the valve is too damaged to repair, valve replacement surgery is performed, where the diseased valve is replaced with either a mechanical or biological prosthetic valve.

Importance of Early Intervention

For patients with a confirmed diagnosis of mitral valve stenosis, early surgical intervention can significantly improve long-term outcomes. Timely treatment helps preserve heart function, reduce symptoms, and delay disease progression. It is crucial for patients to undergo regular follow-up with a cardiologist to monitor the condition and determine the optimal timing for intervention.