Valvular heart disease

2012 ◽  
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Mitral Stenosis ◽  
Acute Rheumatic Fever

General considerations 144Acute rheumatic fever 146Mitral stenosis: clinical features 150Mitral stenosis: investigations 152Mitral stenosis guidelines 156Mitral regurgitation 158Mitral regurgitation guidelines 161Mitral valve prolapse 162Aortic stenosis 164Management of aortic stenosis 168Aortic regurgitation 170Aortic regurgitation guidelines ...

Valvular Heart Disease - Part II

2021 ◽  
Author(s):  
Miriam S. Jacob ◽  
Brian P Griffin
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Developed Countries ◽  
Cardiac Morbidity ◽  
Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications.  This review contains 5 figures, 9 tables, and 53 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

Valvular Heart Disease - Part I

2021 ◽  
Author(s):  
Miriam S. Jacob ◽  
Brian P Griffin
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Developed Countries ◽  
Cardiac Morbidity ◽  
Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications.  This review contains 6 figures, 13 tables, 69 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

Valvular Heart Disease - Part II

2021 ◽  
Author(s):  
Miriam S. Jacob ◽  
Brian P Griffin
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Developed Countries ◽  
Cardiac Morbidity ◽  
Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications.  This review contains 5 figures, 9 tables, and 53 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

Valvular Heart Disease - Part I

2021 ◽  
Author(s):  
Miriam S. Jacob ◽  
Brian P Griffin
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Developed Countries ◽  
Cardiac Morbidity ◽  
Mechanical Prostheses

Valvular heart disease is an important cause of cardiac morbidity in developed countries despite a decline in the prevalence of rheumatic disease in those countries. This chapter discusses the many etiologies of valvular heart disease and presents methods for assessment and management. Specific valvular lesions discussed include mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis, aortic regurgitation, and tricuspid and pulmonary disease. The section on tricuspid disease includes a discussion of mechanical prostheses (ball-in-cage and tilting-disk) and biologic prostheses (xenografts, allografts, and autografts) and their complications.  This review contains 6 figures, 13 tables, 69 references. Keywords: Valvular heart disease, stenosis, regurgitation, mitral regurgitation, mitral valve prolapse (MVP), aortic stenosis, congenital bicuspid valve, senile valvular calcification, aortic regurgitation, chordae or papillary muscles

scholarly journals Contemporary Presentation and Management of Valvular Heart Disease

Circulation ◽  
2019 ◽  
Vol 140 (14) ◽  
pp. 1156-1169 ◽  
Author(s):  
Bernard Iung ◽  
Victoria Delgado ◽  
Raphael Rosenhek ◽  
Susanna Price ◽  
Bernard Prendergast ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Regurgitation ◽  
European Society ◽  
Valvular Heart Disease ◽  
Mitral Stenosis ◽  
Heart Association ◽  
Class I ◽  
European Society Of Cardiology

Background: Valvular heart disease (VHD) is an important cause of mortality and morbidity and has been subject to important changes in management. The VHD II survey was designed by the EURObservational Research Programme of the European Society of Cardiology to analyze actual management of VHD and to compare practice with guidelines. Methods: Patients with severe native VHD or previous valvular intervention were enrolled prospectively across 28 countries over a 3-month period in 2017. Indications for intervention were considered concordant if the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 European Society of Cardiology and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. Results: A total of 7247 patients (4483 hospitalized, 2764 outpatients) were included in 222 centers. Median age was 71 years (interquartile range, 62–80 years); 1917 patients (26.5%) were ≥80 years; and 3416 were female (47.1%). Severe native VHD was present in 5219 patients (72.0%): aortic stenosis in 2152 (41.2% of native VHD), aortic regurgitation in 279 (5.3%), mitral stenosis in 234 (4.5%), mitral regurgitation in 1114 (21.3%; primary in 746 and secondary in 368), multiple left-sided VHD in 1297 (24.9%), and right-sided VHD in 143 (2.7%). Two thousand twenty-eight patients (28.0%) had undergone previous valvular intervention. Intervention was performed in 37.0% and scheduled in 26.8% of patients with native VHD. The decision for intervention was concordant with Class I recommendations in symptomatic patients with severe single left-sided native VHD in 79.4% (95% CI, 77.1–81.6) for aortic stenosis, 77.6% (95% CI, 69.9–84.0) for aortic regurgitation, 68.5% (95% CI, 60.8–75.4) for mitral stenosis, and 71.0% (95% CI, 66.4–75.3) for primary mitral regurgitation. Valvular interventions were performed in 2150 patients during the survey; of them, 47.8% of patients with single left-sided native VHD were in New York Heart Association class III or IV. Transcatheter procedures were performed in 38.7% of patients with aortic stenosis and 16.7% of those with mitral regurgitation. Conclusions: Despite good concordance between Class I recommendations and practice in patients with aortic VHD, the suboptimal number in mitral VHD and late referral for valvular interventions suggest the need to improve further guideline implementation.

Thromboembolism and bleeding complications in anticoagulated patients with atrial fibrillation and native aortic or mitral valvular heart disease: a descriptive nationwide cohort study

2020 ◽  
Author(s):  
Line Melgaard ◽  
Thure Filskov Overvad ◽  
Martin Jensen ◽  
Gregory Y H Lip ◽  
Torben Bjerregaard Larsen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Major Bleeding ◽  
Valvular Heart Disease ◽  
Mitral Stenosis ◽  
Vitamin K Antagonist ◽  
Bleeding Complications ◽  
Using Data ◽  
Anticoagulated Patients

Abstract Aims To describe the risks of thromboembolism and major bleeding complications in anticoagulated patients with atrial fibrillation (AF) and native aortic or mitral valvular heart disease using data reflecting clinical practice. Methods and results Descriptive cohort study of anticoagulated patients with incident AF and native aortic or mitral valvular heart disease, identified in nationwide Danish registries from 2000 to 2018. A total of 10 043 patients were included, of which 5190 (51.7%) patients had aortic stenosis, 1788 (17.8%) patients had aortic regurgitation, 327 (3.3%) patients had mitral stenosis, and 2738 (27.3%) patients had mitral regurgitation. At 1 year after AF diagnosis, the risk of thromboembolism was 4.6% in patients with mitral stenosis taking a vitamin K antagonist (VKA), and 2.6% in patients with aortic stenosis taking a VKA or non-vitamin K antagonist oral anticoagulant (NOAC). For patients with aortic or mitral regurgitation, the risks of thromboembolism ranged between 1.5%-1.8% in both treatment groups. For the endpoint of major bleeding, the risk was ∼5.5% in patients with aortic stenosis or mitral stenosis treated with a VKA, and 3.3–4.0% in patients with aortic or mitral regurgitation. For patients treated with a NOAC, the risk of major bleeding was 3.7% in patients with aortic stenosis and ∼2.5% in patients with aortic or mitral regurgitation. Conclusion When using data reflecting contemporary clinical practice, our observations suggested that 1 year after a diagnosis of AF, anticoagulated patients with aortic or mitral valvular heart disease had dissimilar risk of thromboembolism and major bleeding complications. Specifically, patients with aortic stenosis or mitral stenosis were high-risk subgroups. This observation may guide clinicians regarding intensity of clinical follow-up.

scholarly journals Type of Valvular Heart Disease Requiring Surgery in the 21st Century: Mortality and Length-of-Stay Related to Surgery

2013 ◽  
Vol 7 (1) ◽  
pp. 104-109 ◽  
Author(s):  
Konstantinos Dean Boudoulas ◽  
Yazhini Ravi ◽  
Daniel Garcia ◽  
Uksha Saini ◽  
Gbemiga G. Sofowora ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Length Of Stay ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Valvular Heart Disease ◽  
Aortic Insufficiency ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Surgical Mortality

Aim: While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital. Methods: Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed. Results: From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac proce-dures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5% (replacement 3.4%; repair 1.6%), 3.9%, 5.6% and 5.8%, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2% (p<0.005 compared to single valve surgery). Conclusions: Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions.

scholarly journals Clinical profile of acute rheumatic fever patients attending a tertiary care hospital in eastern Bihar, India

2017 ◽  
Vol 4 (5) ◽  
pp. 1218
Author(s):  
Shanker Suman ◽  
Rakesh Kumar ◽  
Divya Jyoti ◽  
Pramod Kumar Agrawal ◽  
Vishal Parmar
Keyword(s):  
Heart Disease ◽  
Mitral Regurgitation ◽  
Rheumatic Fever ◽  
Aortic Regurgitation ◽  
Rheumatic Heart Disease ◽  
Joint Pain ◽  
Acute Rheumatic Fever ◽  
Care Hospital ◽  
Autoimmune Reaction ◽  
Rheumatic Heart

Background: Acute rheumatic fever (ARF) is a multisystem disease resulting from an autoimmune reaction to infection with group A beta haemolytic streptococcus. Acute rheumatic fever commonly occurs between 5-14 years of age.1 The major concern relating to acute rheumatic fever is often not the episode itself but the long-term consequences of damage to heart valves (Rheumatic heart disease (RHD) that often results from recurrent episodes of acute rheumatic fever. Rheumatic heart disease (RHD) continues to be a major public health problem and a common cause of morbidity and mortality in many parts of India.2Methods: 50 consecutive patients admitted with the diagnosis of acute rheumatic fever in Medicine Department, Katihar Medical College and Hospital, Bihar, India were studied. A detailed clinical history of these patients including presenting symptoms were noted. Physical examination of all systems was done and a diagnosis of acte rheumatic fever was made according to WHO Criteria (2002-2003) for the diagnosis of rheumatic fever and rheumatic heart disease (Based on the Revised Jones Criteria). Echocardiography of all 50 patients were done.Results: Mean age of patients diagnosed with ARF was 14.20±7.02 years. Out of 50 patients, 32 (64%) were female and 18 (36%) were male. Joint pain was the commonest presenting complain, 35 (70%) patients, followed by fever in 21 (42%) patients. Among Jones major manifestations 36 (72%) cases had carditis, 32 (64%) had arthritis, 6 (12%) had subcutaneous nodules, 5 (10%) had erythema marginatum and5(10%) had Sydenham’s chorea. In patients with carditis, 25 (69.44%) had mitral regurgitation (MR) only while 10 (27.77%) had MR with aortic regurgitation (AR) and 1 (2.77%) patient had organic tricuspid regurgitation (TR) with mitral regurgitation and aortic regurgitation. Out of 36 patients with carditis, 10 (27.77%) patients did not have any clinical evidence of carditis and were detected by echocardiography only.Conclusions: Commonest complain in patients with rheumatic fever was joint pain followed by fever. In patients with carditis, all had mitral regurgitation(MR), with 1/3rd of these patients having associated aortic regurgitation(AR). 1/3rd of patients with carditis were detected by echo only and therefore, echo should be included in diagnostic criteria for acute rheumatic fever. None of the patients who developed rheumatic fever was on penicillin prophylaxis.

Valvular heart disease (Aortic regurgitation and mitral valve prolapse) among institutionalized adults with down's syndrome

1986 ◽  
Vol 57 (4) ◽  
pp. 278-281 ◽  
Author(s):  
Samuel Z. Goldhaber ◽  
I.Leslie Rubin ◽  
Wayne Brown ◽  
Neil Robertson ◽  
Frances Stubblefield ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Aortic Regurgitation ◽  
Valvular Heart Disease ◽  
Mitral Valve Prolapse ◽  
Down's Syndrome ◽  
Down’S Syndrome

scholarly journals Pattern of Heart Valve Involvement in Rheumatic Heart Disease

2017 ◽  
Vol 6 (1) ◽  
pp. 17-22
Author(s):  
Rajendra Koju ◽  
R Gurung ◽  
P Pant ◽  
B Pokharel ◽  
TRS Bedi
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Aortic Stenosis ◽  
Rheumatic Heart Disease ◽  
Mitral Stenosis ◽  
Acute Rheumatic Fever ◽  
Severe Aortic Stenosis ◽  
Therapeutic Options ◽  
Study Population ◽  
Rheumatic Heart

Rheumatic heart disease is the most important consequence of acute rheumatic fever. Both are common cardiovascular problems in Nepal. Echocardiographic detection of rheumatic heart disease is important to establish the diagnosis. The involvement of valves and their severity guides the therapeutic options. A total of 133 valvular heart disease cases attended in Dhulikhel Hospital between July 2008 to June 2009 were analyzed. Fifty-one patients, in whom the problems were rheumatic in origin were studied. Among them, 12% (6) had isolated aortic valve involvement, 35%(18) had isolated mitral valve and 53%(27) ahd mixed involvement. Severe mitral stenosis accounts for 24% of all mitral stenosis and severe aortic stenosis is 20% fo all aortic stenosis. The rates for severe mitral regurgitation and severe aortic regurgitaiton are 30% and 28% respectively. Although the study population has a high number of female patients, the differences in the rates of involvement of aortic or mitral valve in both genders are statistically insignificant. The study, although small, confirms that in this population, females are more commonly affected, that the mitral valve is the most commonly damaged valve and that disease affecting multiple valves is marginally more common than isolated valve disease. The detection of valvular involvement at different stages can guide the therapeutic options.

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