Mitral Stenosis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Mitral Stenosis?
A cardiologist, a heart doctor, usually treats mitral stenosis. A heart surgeon repairs or replaces the valve when that is needed. A primary care doctor can help find the problem and arrange follow-up. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is mitral stenosis?
Mitral stenosis is a disorder in which the mitral valve does not fully open. This restricts the flow of blood.
When the valve cannot open enough, less blood flows to the body. The upper heart chamber swells as pressure builds up. Blood and fluid may then collect in the lung tissue, called pulmonary edema, which makes it hard to breathe.
Symptoms
Adults may have no symptoms. Symptoms may appear or get worse with exercise or other activity that raises the heart rate. They most often start between ages 40 and 50, but can start earlier or later depending on the cause. They may include:
- Trouble breathing during or after exercise. This is the most common symptom.
- Waking up because of breathing problems, or trouble breathing when lying flat.
- Cough, possibly with bloody phlegm.
- Fatigue, which means feeling very tired.
- Frequent respiratory (breathing) infections, such as bronchitis.
- A pounding heartbeat, called palpitations.
- Swollen feet or ankles.
- Chest discomfort that gets worse with activity. This is rare.
Symptoms may start with an episode of atrial fibrillation, an abnormal heart rhythm, especially if it causes a fast heart rate. Pregnancy or other stress on the body can also trigger them.
Causes and who gets it
In adults, mitral stenosis occurs most often in people who have had rheumatic fever. This is a disease that can develop after strep throat that was not properly treated. Rheumatic fever is rare in the United States because strep infections are most often treated. This has made mitral stenosis less common.
Rarely, adults can get it from calcium deposits around the valve, radiation treatment to the chest, or some medicines. Children may be born with mitral stenosis, often along with other heart defects. It may run in families.
How doctors diagnose it
Your provider listens to your heart and lungs with a stethoscope. A murmur, snap, or other abnormal heart sound may be heard.
An echocardiogram uses sound waves to make moving pictures of the heart. It is the most common test for heart valve problems. An electrocardiogram, or ECG, records the heart's electrical activity. A chest x-ray, an MRI or CT of the heart, or a transesophageal echocardiogram may also be used.
Treatment
Treatment depends on the symptoms and the condition of the heart and lungs. People with mild symptoms or none at all may not need treatment.
Medicines can treat symptoms of heart failure, treat high blood pressure, and slow or regulate heart rhythms. They include water pills (diuretics), beta-blockers, calcium channel blockers, ACE inhibitors, and other heart medicines. Blood thinners are used to prevent blood clots from forming and traveling to other parts of the body.
People who have had rheumatic fever may need long-term preventive treatment with an antibiotic such as penicillin.
Some people need a procedure or heart surgery. In balloon valvotomy, also called valvuloplasty, a catheter is inserted into a vein, usually in the leg, and threaded up into the heart. A balloon on its tip is inflated to widen the valve and improve blood flow. Even when it works, it may need to be repeated months or years later.
Surgery can repair or replace the mitral valve. Replacement valves can be mechanical or biological. Biological valves are made from animal tissue and do not require blood thinners, but they do not last as long. Mechanical valves last longer, but need blood-thinning medicine for life. Risks of valve replacement include stroke, blood clots, and bleeding where the catheters were inserted.
When to see a doctor
Contact your provider if you have symptoms of mitral stenosis. Also call if you already have it and your symptoms do not improve with treatment, or new symptoms appear.
Call 911 or go to the emergency room if you have severe trouble breathing, chest pain or discomfort that lasts two minutes or more, you faint, you cough up blood, or you have sudden weakness, sudden dizziness, a change in vision, or you cannot speak.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can do a first evaluation, refer you to a cardiologist, and see you for regular visits to review your symptoms and medicines.
Common questions
How serious is mitral stenosis?
It can be serious. The outcome varies. It may be mild without symptoms, or it may become disabling over time. Complications may be severe or life threatening.
What problems can mitral stenosis cause?
It can cause atrial fibrillation and atrial flutter, which are abnormal heart rhythms. It can also cause blood clots that travel to the brain (stroke), intestines, kidneys, or other areas. Other problems are congestive heart failure, pulmonary edema, and pulmonary hypertension, which is high blood pressure in the lungs.
How can I lower my risk of mitral stenosis?
You can lower your risk by treating strep infections quickly, because this prevents rheumatic fever, the most common cause in adults. People with damaged heart valves are also at risk for an infection called endocarditis. To lower that risk, avoid unclean injections and tell your provider and dentist about any history of heart valve disease before treatment.
Sources
- MedlinePlus - Mitral stenosis: MedlinePlus Medical Encyclopedia
- National Heart, Lung, and Blood Institute - Heart Valve Diseases: Treatment
- National Heart, Lung, and Blood Institute - Heart Valve Diseases: Diagnosis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
