Physical examination for mitral valve stenosis

After discussing your medical history and all current symptoms, your doctor will perform a physical exam to look for signs of mitral valve stenosis, complications, and any other conditions you may have. Your doctor will suspect mitral valve stenosis if he or she hears a distinctive sound while listening to your heart with a stethoscope.

If mild mitral valve stenosis is causing a murmur, the murmur may be very faint and your doctor may ask you either to exercise for a few minutes to increase your heart rate or to lie on your left side. The murmur may then be heard more easily. In some cases, mitral valve stenosis may also result in a thrill, a vibration caused by the turbulent blood flow that your doctor can feel on your chest.

Two sets of sounds make up your heartbeat—one that represents the valves of your left and right atria (mitral and tricuspid valves) closing, and one that represents the valves of your left and right ventricles (aortic and pulmonic valves) closing. If your mitral valve becomes severely narrowed, your doctor will hear a loud first sound as your mitral valve closes.

Although a certain type of heart murmur is strong clinical evidence of mitral valve stenosis, it does not necessarily confirm the diagnosis. Other valve conditions also cause murmurs that may obscure or be obscured by the murmurs indicative of mitral valve stenosis. An echocardiogram will confirm the diagnosis and rule out any other valve problem as a cause of the murmur.

Because many of the symptoms of heart failure are the same as those of mitral valve stenosis, your doctor will also examine you for signs of this condition. In particular, your doctor will listen for a crackling or wheezing in your lungs, which may indicate that fluid has backed up into your lungs because of your heart's inability to pump blood forward through your mitral valve. Mitral valve stenosis also often causes high blood pressure in your lungs (pulmonary hypertension), which can also cause shortness of breath.

Last Updated: February 10, 2010

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