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Initially, symptoms of mitral valve stenosis are mild. Some people have no symptoms at all; but as the valve opening narrows and blood flow is restricted, patients feel fatigue, shortness of breath with minimal exercise and palpitations. Because blood and fluid back up into the lungs, they may also have a heavy cough, frequent respiratory infections, or difficulty breathing while lying down. In later stages, complications may include signs of more several heart failure such as lung congestion and/or chest pain, swollen feet or ankles, arrhythmias or atrial fibrillation, pulmonary hypertension, blood clots in lungs, heart valve infection or stroke.