After discussing your medical history and any 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.