Contents

Search

valvular heart disease

Any disease process involving one or more of the heart valves. Classification: - aortic valve disease - aortic stenosis - aortic insufficiency - mitral valve disease - mitral stenosis - mitral insufficiency - tricuspid valve disease - tricuspid stenosis - tricuspid insufficiency - pulmonary valve disease - pulmonary valve stenosis - pulmonary valve insufficiency Etiology: - congenital - tetralogy of Fallot - Ebstein's anomaly - acquired - rheumatic heart disease - endocarditis - see more specific type Clinical manifestations: - valvular heart disease often progresses slowly with patients unaware but gradually limiting activity in response to its progression [5] Staging: - stage A: risk factors - stage B: asymptomatic but progressive, mild-to-moderate valvular heart disease - stage C: asymptomatic but severe valvular heart disease - stage C1: compensation of affected ventricle - stage C2: decompensation of affected ventricle - stage D: symptomatic severe valvular heart disease [7] Management: - surgical repair or replacement is indicated in severe valvular disease with symptoms of ventricular dysfunction - surgical team of cardiologist, cardiac surgeon & interventional cardiologist [5] - mechanical valve or bioprosthetic valve may be appropriate for patient age 50-70 years [11] - medical therapy alone does not slow progression or prolong survival [5] - antibiotic prophylaxis for certain dental procedures is reasonable for high-risk patients with prosthetic valves [11]

Interactions

disease interactions

Specific

aortic sclerosis bicuspid aortic valve Ebstein's anomaly endocarditis mitral valve prolapse (MVP) pulmonary atresia pulmonic valve disease regurgitant valvular heart disease rheumatic heart disease tetralogy of Fallot tricuspid valve disease

General

heart disease (cardiac disease)

References

  1. Centers for Disease Control & Prevention (CDC) Valvular Heart Disease https://www.cdc.gov/heartdisease/valvular_disease.htm
  2. Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'gara PT, O'rourke RA, Otto CM, Shah PM, Shanewise JS, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2006 Aug 1;48(3):598-675. No abstract available. PMID: 16876001 http://www.acc.org/clinical/guidelines/valvular/index.pdf - Bonow RO, Carabello BA, Chatterjee K 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008 Sep 23;52(13):e1-142. PMID: 18848134
  3. Nkomo VT et al, Burden of valvular heart diseases: A population-based study. Lancet 2006, 368:1005 PMID: 16980116
  4. Wikipedia: Valvular heart disease http://en.wikipedia.org/wiki/Valvular_heart_disease
  5. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2022.
  6. Bonow RO, Carabello BA, Chatterjee K et al 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008 Oct 7;118(15):e523-66 PMID: 18820172 - Bonow RO, Carabello BA, Chatterjee K et al 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008 Sep 23;52(13):e1-142. PMID: 18848134
  7. Nishimura RA et al 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, March 3, 2014 PMID: 24589853 http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000031 - Nishimura RA et al. AHA/ACC guideline for the management of patients with valvular heart disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014 Mar 7 PMID: 24603192 http://www.sciencedirect.com/science/article/pii/S0735109714012807
  8. Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) et al Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012 Oct;33(19):2451-96 PMID: 22922415 (corresponding NGC guideline withdrawn Jan 2018
  9. Helms AS, Bach DS. Heart valve disease. Prim Care. 2013 Mar;40(1):91-108 PMID: 23402463
  10. Leong DP, Joseph MX, Selvanayagam JB The evolving role of multimodality imaging in valvular heart disease. Heart. 2014 Feb;100(4):336-46. PMID: 23574967
  11. Nishimura RA, Otto CM, Bonow RO et al 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. March 15, 2017 PMID: 28298458 http://circ.ahajournals.org/content/early/2017/03/14/CIR.0000000000000503 - Nishimura RA, Otto CM, Bonow RO et al 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jun 10;63(22):e57-185. PMID: 24603191 Free Article - Nishimura RA, Otto CM, Bonow RO et al 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Jul 11;70(2):252-289. PMID: 28315732 Free Article
  12. Otto CM et al 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease. A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021;143:e00 PMID: 33332150 https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000923
  13. Davidson LJ, Davidson CJ Transcatheter Treatment of Valvular Heart Disease. A Review. JAMA. 2021;325(24):2480-2494 PMID: 34156404 https://jamanetwork.com/journals/jama/fullarticle/2781245