Mitral Valve Stenosis and Its Connection to Right Ventricular Hypertrophy

Mitral valve stenosis is a condition rooted in the abnormal narrowing of the mitral valve, which is responsible for controlling blood flow between the left atrium and left ventricle of the heart. When this valve fails to open properly, it restricts the flow of blood, creating a cascade of hemodynamic changes that can significantly impact heart function.

Understanding the Pathophysiology

During the heart's relaxation phase, known as diastole, the left atrium is unable to efficiently pump blood into the left ventricle due to the narrowed mitral valve. This obstruction leads to a buildup of blood in the left atrium, causing it to dilate over time. As the pressure within the left atrium rises, it is transmitted back to the pulmonary circulation, resulting in elevated pulmonary artery pressures.

The Role of Pulmonary Hypertension

Chronic elevation of pulmonary artery pressure places a significant burden on the right side of the heart, particularly the right ventricle. The right ventricle must work harder to pump blood through the lungs against this increased resistance. Initially, the heart compensates by thickening the right ventricular wall—a process known as hypertrophy.

Progression to Right Ventricular Failure

While right ventricular hypertrophy is initially a compensatory mechanism, prolonged pressure overload eventually leads to decompensation. The right ventricle becomes unable to maintain adequate cardiac output, leading to symptoms of heart failure such as fatigue, fluid retention, and shortness of breath. This progression highlights the importance of early diagnosis and management of mitral valve stenosis to prevent irreversible changes in heart structure and function.