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How to manage progressive mitral stenosis?

Q: I am having mild mitral stenosis. It was diagnosed in 1990 and at that time the size of section was 2.1cm2. I usually get the echo doppler test every year. Now the size is 1.6 cm2. I am 40 year old male. Please guide me as the size of the valve is getting reduced; what should be done at this stage?

A:Mitral stenosis is a part of the generalised process of rheumatic heart disease and is a slowly progressive ongoing disease. There is very little that you can do at the age of 40 to prevent onward progression of the disease and all you can do is possibly what you are already doing that is regular medical follow ups. Mitral valve size of 1.6cm2 is still moderate stenosis and if you do not have any symptoms then one needs to be on regular medical follow up only and no form of intervention should be done. However, if the valve area progressively reduces and it comes to 1.0 cm2 or if you become symptomatic and develop symptoms of breathing difficulty on walking then this valve will need to be opened. The valve can be opened now days by what you call balloon mitral valvotomy or a technique in which no anaesthesia and no cuts are involved and it is a non surgical technique which is performed by the cardiologist. However, in certain patients where balloon mitral valvotomy is not feasible then a open heart surgical procedure may need to be undertaken. I suppose, if you are getting your echo doppler done every year then a good cardiologist would also be following you up and he would guide you appropriately. I hope I have answered your queries to your satisfaction but if you still have any doubts, please feel free to contact us and it shall be our pleasure to do the needful.

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