What is the difference between mitral stenosis and mitral regurgitation

These interventional procedures may help if you cannot undergo surgery for regurgitation or if the stenosis is due to rheumatic fever. Procedures include:. Our surgeons and interventional cardiologists work together to explore new and promising nonsurgical, catheter-based treatments. Clinical trials include:. We participate in a wide range of insurance plans. View the list of insurance plans accepted by Stanford Health Care ». Have insurance or pre-authorization questions? Please call or toll free.

View a list of Interventional Cardiology doctors ». We offer a number of support services at the Heart and Vascular Center, including a Lifestyle Modification program, support groups, integrative medicine, nutrition services, a health library, and a variety of classes and events.

Learn more about our support services ». You can call the Interventional Cardiology clinic directly to schedule an appointment with a Stanford Health Care doctor. Call to make an appointment. We constantly search for better ways to protect your heart and blood vessels.

The following are some examples of our ongoing clinical innovation. Yes, Stanford Health Care offers financial assistance for patients who are uninsured or underinsured. Meet with one of our financial counselors to find the best approach to paying for your health care. Financial counselors are available Monday through Friday from a.

Learn more about financial assistance services ». Each of our doctors is scheduled to see patients only one day a week in the clinic. Other time obligations include performing procedures, routine patient management, and research and academic commitments. Managing treatment for heart disease is a highly personalized process.

Our care team guides you every step of the way. If your medical records have not yet been received by our office, one of our staff will advise you on how to obtain them, including:. If your medical records have not yet been received by our office, one of our staff will advise you on obtaining them, including:. The Interventional Cardiology Clinic is located at the following address.

Valet and self-parking options are available for a fee. For more information, please see:. Please plan to arrive 30 minutes prior to your appointment time due to construction near the main hospital campus. This will allow you plenty of time to park, locate your clinic, and complete any additional paperwork. Please print, fill out, and return the Medical Record Release Form to your new patient coordinator.

The medical release form is an authorization form for external facilities to release medical records to Stanford Health Care.

Please call our clinic receptionists at They are available Monday through Friday, a. Always feel free to bring someone with you to your appointments. A family member or friend can help ask questions, remember the information your care team gives you, and provide support.

By California state law, you must let your care team know that you would like to record your conversation if you would like help remembering your discussion with your care team. Write down your questions before your appointment and rank them in order of importance, beginning with the most important ones. If there is not enough time to have all of your questions answered during your appointment, ask your doctor who you can speak with to get your remaining questions answered.

Forgot Username? Forgot Password? Contact the MyHealth Help Desk. For our latest business hours and for more information about billing, visit our Billing page. To determine if a clinical trial is right for you, talk to your doctor. He or she can refer you to a research coordinator for more information on studies that may be right for your specific condition. You can also find the guidelines for who can participate in a particular clinical trial online.

However, it is best to work with your doctor to decide the right care approach for your needs. View list of open interventional cardiology clinical trials at Stanford. Our International Medicine Services team can help you find the right doctor, estimate medical costs, book travel, and get you information about Stanford programs and services. To schedule an appointment, please call: The parachute-shaped valve is complex because it contains many parts and sits in the back of the heart.

There are two types of mitral valve malfunctions:. The Stanford Valvular Heart Disease Clinic brings together different disciplines for a team approach to diagnosis and treatment.

Whenever possible, our team of cardiologists aims to repair your valve. When necessary, we offer the top options for valve replacement. The Stanford Interventional Cardiology program is a leader in minimally invasive procedures for diagnosing and treating heart valve disease.

Our team of interventional cardiologists typically sees new patients within two weeks. Mitral Valve Stenosis and Regurgitation Our expertise in minimally invasive repair for mitral valve stenosis and regurgitation is recognized nationwide. The volume and pressure from blood remaining in the left atrium increases which causes the left atrium to enlarge and fluid to build up in the lungs.

Mitral stenosis can be caused by congenital heart defects, mitral valve prolapse, rheumatic fever, lupus and other conditions. Rheumatic fever PDF is a childhood illness that sometimes occurs after untreated strep throat or scarlet fever. Rheumatic fever is rare in high-income countries such as the United States but remains a concern in some low- and middle-income nations. Rheumatic fever can damage the heart valves leading to rheumatic heart disease.

Mitral stenosis resulting from RHD is called rheumatic mitral stenosis. Although most mitral stenosis is caused by RHD, it can also result from a calcium build up on the heart valves. This is more common in older patients and is called calcific mitral stenosis. The mitral valve can usually be repaired or replaced with surgery, or a minimally invasive procedure. The choice of procedure is based on many factors including the cause of the mitral stenosis rheumatic or calcific , condition of the valve, risk of surgery, severity of symptoms, heart function, and availability of procedures.

Mitral Valve Commissurotomy For rheumatic mitral stenosis, a commissurotomy may be performed. During this procedure the valve leaflets that have become fused together are separated. This can be done using a balloon percutaneous mitral balloon commissurotomy or PMBC or surgery.

All patients should be encouraged to continue at least low levels of physical exercise despite exertional dyspnea. It may cause fever, heart murmurs, petechiae, anemia, embolic Moderate mitral stenosis intervention may be indicated when cardiac surgery is required for other indications. Cardiac surgery is only pursued when symptoms are severe and for patients who are not candidates for percutaneous balloon commissurotomy or require other cardiac operations or do not have access to the percutaneous procedure.

Percutaneous balloon commissurotomy is the procedure of choice for younger patients and for patients without heavily calcified valve commissures, subvalvular distortion, LA thrombi, or moderate or severe MR see Table Grading of Mitral Regurgitation Grading of Mitral Regurgitation Mitral regurgitation MR is incompetency of the mitral valve causing flow from the left ventricle LV into the left atrium during ventricular systole.

In this fluoroscopic- and echocardiographic-guided procedure, a transvenous catheter with an inflatable distal balloon is passed transseptally from the right atrium to the LA and inflated to separate fused mitral valve commissures. Outcomes are equivalent to those of more invasive procedures.

Complications are uncommon but include MR, embolism, and tamponade Cardiac Tamponade Cardiac tamponade is accumulation of blood in the pericardial sac of sufficient volume and pressure to impair cardiac filling. Patients typically have hypotension, muffled heart tones, and distended Surgical commissurotomy may be used in patients with severe subvalvular disease, valvular calcification, or LA thrombi.

In this procedure, fused mitral valve leaflets are separated using a dilator passed through the left ventricle closed commissurotomy via a thoracotomy, or by direct vision open commissurotomy via a sternotomy. During surgery, some clinicians ligate the left atrial appendage to reduce thromboembolism.

Valve replacement is confined to patients with severe morphologic changes that make the valve unsuitable for balloon or surgical commissurotomy. Lifelong anticoagulation with warfarin is required in patients with a mechanical valve to prevent thromboembolism. A mitral bioprosthetic valve requires anticoagulation with warfarin for 3 to 6 months postoperatively see also Anticoagulation for patients with a prosthetic cardiac valve Anticoagulation for patients with a prosthetic cardiac valve Any heart valve can become stenotic or insufficient also termed regurgitant or incompetent , causing hemodynamic changes long before symptoms.

Direct-acting oral anticoagulants DOAC are ineffective and should not be used. When the etiology is annular calcification, there is no benefit from percutaneous balloon commissurotomy because there is no commissural fusion. Furthermore, surgical valve replacement is technically demanding because of the annular calcification and often high risk because many patients are older and have comorbidities.

Therefore, intervention is delayed until symptoms become severe despite use of diuretic and rate control drugs. Preliminary experience in inoperable patients suggests benefit from implantation of a transcatheter aortic valve replacement TAVR bioprosthesis in the mitral position.

Circulation 5 :e35—e71, The risk of thromboembolism in patients with atrial fibrillation and mitral stenosis is very high and is treated with a vitamin K antagonist, not a direct-acting oral anticoagulant. Heart sounds include a loud S1 and an early diastolic opening snap followed by a low-pitched decrescendo-crescendo rumbling diastolic murmur, heard best at the apex at end-expiration when the patient is in the left lateral decubitus position; the murmur increases after a Valsalva maneuver, exercise, squatting, and isometric handgrip.

Mildly symptomatic patients usually respond to diuretics and, if sinus tachycardia or atrial fibrillation is present, to beta-blockers or calcium channel blockers for rate control. Severely symptomatic patients and those with evidence of pulmonary hypertension require commissurotomy or valve replacement. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.

The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. This site complies with the HONcode standard for trustworthy health information: verify here. Common Health Topics. Videos Figures Images Quizzes Symptoms. Symptoms and Signs. Palpation Auscultation. Timing of intervention Choice of intervention Treatment reference. Key Points.

Valvular Disorders. Test your knowledge. Aortic stenosis AS occurs when the aortic valve narrows, obstructing blood flow from the left ventricle to the ascending aorta during systole. There are several different causes of AS, and the causes differ among age groups. However, in low and middle income countries, which of the following is the most common cause of AS in all age groups? More Content. Mitral Stenosis By Guy P. Click here for Patient Education.

Loud S1. Mid-diastolic murmur of obstructing left atrial myxoma or ball thrombus rare. Severity of mitral stenosis is characterized echocardiographically as. Diuretics and sometimes beta-blockers or calcium channel blockers. Mitral stenosis is almost always caused by rheumatic fever. Was This Page Helpful?