Complications Of Mitral Valve Disease

There are three mitral valve diseases, let us see what the complications of each mitral valve disease are.

Complications Of Mitral Stenosis

Atrial Fibrillation. Atrial fibrillation (AF) is the most common complication of mitral stenosis (MS). It is estimated that 40% of patients with mitral stenosis get atrial fibrillation. It develops due to the enlargement of the left atrium and increase in the left atrial pressure. When this happens the electrophysiology of the atrium gets disrupt with the stretching of the atrial muscle. Initially the atrial fibrillation occurs paroxysmal atrial fibrillation (which occurs as spasm, at times), with time atrial fibrillation becomes permanent but it responses to antiarrhythmic drugs. If mitral stenosis is not treated then after sometime atrial fibrillation becomes treatment resistant due to the enlarged left atrium. After this stage even with mitral valve replacement atrial fibrillation might not respond to anti arrhythmic drugs. Most of the time it is the symptoms of atrial fibrillation like palpitations or other devastating symptoms that actually diagnose the mitral stenosis. If it was a known case of mitral stenosis with minimum symptoms the atrial fibrillation causes more disability and complications. Therefore, it is important you follow up with your doctor regularly to identify atrial fibrillation at an initial stage so, that treatment can be carried out.

Complications Of Mitral Valve Disease

Systemic Embolism (Thromboembolism). Systemic embolism occurs because of atrial fibrillation. With atrial fibrillation there is thrombus formation in the left atrium and these get detached, travel through the blood and block the arteries in other organs. This is called embolism and it cut downs the blood supply to that part of the blood. Systemic embolism commonly occurs in the cerebral arteries which lead to a stroke or other neurological sequalae. It is said that 9-14% of patients with mitral stenosis develop systemic embolism. The development of stroke leads to the diagnosis of mitral stenosis, most of the patients who are asymptomatic with mitral stenosis develop neurological problems suddenly which can be devastating. Mitral valve replacement does not reduce the risk of systemic embolism completely.

Infective Endocarditis. This is rare in patients with pure mitral stenosis, but it can occur if you also have aortic stenosis or mitral regurgitation.

Pulmonary Hypertension. This is a complication that occurs with time when mitral stenosis is not treated. This can lead to heart failure.

Pulmonary Infarctions. This is another type of systemic embolism where the emboli dislodge in the pulmonary artery, however, this is much rare than the cerebral embolism.

Recurrent Chest Infections. Due to the pulmonary hypertension and pulmonary edema there is stagnation of mucus in the lungs which can be a good place for the organisms to grow.

Right heart failure is also a complication of mitral stenosis.

Complications Of Mitral Regurgitation

Pulmonary edema is a complication of mitral regurgitation.

Congestive Heart Failure. Initially left heart failure occurs and with time right heart also fails which leads to congestive heart failure.

Irreversible Left Ventricular (LV) Systolic Dysfunction. Since, some amount of blood is regurgitated the cardiac output reduce, the left ventricle contract more to maintain a normal cardiac output which leads to left ventricular systolic dysfunction.

Thromboembolism Resulting From Atrial Fibrillation. Atrial fibrillation is not commonly seen in mitral regurgitation (MR) as seen in mitral stenosis, however it can occur when the atrium is enlarged and even give rise to systemic embolism.

Complications Of Mitral Valve Prolapse

  • Mitral regurgitation
  • Heart failure
  • Infective endocarditis
  • Atrial fibrillation and thromboembolism


Complications of mitral stenosis are atrial fibrillation which is the most common one and occurs in about 40% of mitral stenosis patients. Next is systemic embolism which occurs due to atrial fibrillation. Other complications of mitral stenosis are pulmonary hypertension, pulmonary infarction, infective endocarditis and recurrent chest infections. Complications of mitral regurgitation are pulmonary edema, congestive cardiac failure, irreversible left ventricular (LV) systolic dysfunction, and thromboembolism resulting from atrial fibrillation. Complications of mitral valve prolapse are mitral regurgitation, heart failure, infective endocarditis, and atrial fibrillation and thromboembolism.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:December 22, 2023

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