Valvular heart disease echocardiography or ultrasound

Valvular heart disease Microchapters
Patient Information
Classification Aortic stenosis Aortic regurgitation Mitral stenosis Mitral valve prolapse Mitral regurgitation Tricuspid stenosis Tricuspid regurgitation Pulmonary stenosis Pulmonary regurgitation
Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary

Class I

"1. Transthoracic echocardiography (TTE) is recommended in the initial evaluation of patients with known or suspected valvular heart disease to confirm the diagnosis, establish etiology, determine severity, assess hemodynamic consequences, determine prognosis, and evaluate for the timing of intervention. (Level of Evidence: B)"

"2. Transthoracic echocardiography is recommended in patients with known valvular heart disease with any change in symptoms or physical examination findings. (Level of Evidence: C)"

"3. Periodic monitoring with Transthoracic echocardiography is recommended in asymptomatic patients with known valvular heart disease at intervals depending on valve lesion, severity, ventricular size, and ventricular function. (Level of Evidence: C)"

2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT)

Recommendations for Echocardiography (DO NOT EDIT)

Class I

"1. Echocardiography is recommended for asymptomatic patients with diastolic murmurs, continuous murmurs, holosystolic murmurs, late systolic murmurs, murmurs associated with ejection clicks or murmurs that radiate to the neck or back. (Level of Evidence: C) "

"2. Echocardiography is recommended for patients with heart murmurs and symptoms or signs of heart failure, myocardial ischemia/infarction, syncope, thromboembolism, infective endocarditis, or other clinical evidence of structural heart disease. (Level of Evidence: C)"

"3. Echocardiography is recommended for asymptomatic patients who have grade 3 or louder midpeaking systolic murmurs. (Level of Evidence: C)"

Class III (Harm)

"1. Echocardiography is not recommended for patients who have a grade 2 or softer midsystolic murmur identified as innocent or functional by an experienced observer. (Level of Evidence: C) "

Class IIa

"1. Echocardiography can be useful for the evaluation of asymptomatic patients with murmurs associated with other abnormal cardiac physical findings or murmurs associated with an abnormal ECG or chest X-ray. (Level of Evidence: C)"

"2. Echocardiography can be useful for patients whose symptoms and/or signs are likely noncardiac in origin but in whom a cardiac basis cannot be excluded by standard evaluation. (Level of Evidence: C)"

Aortic Stenosis Asymptomatic Patient (DO NOT EDIT)

Class I

"1. Echocardiography is recommended for the diagnosis and assessment of AS severity. (Level of Evidence: B) "

"2. Echocardiography is recommended in patients with AS for the assessment of LV wall thickness, size, and function. (Level of Evidence: B) "

"3. Echocardiography is recommended for re-evaluation of patients with known AS and changing symptoms or signs. (Level of Evidence: B) "

"4. Echocardiography is recommended for the assessment of changes in hemodynamic severity and LV function in patients with known AS during pregnancy. (Level of Evidence: B) "

"5. Transthoracic echocardiography is recommended for re-evaluation of asymptomatic patients: every year for severe AS; every 1 to 2 years for moderate AS; and every 3 to 5 years for mild AS. (Level of Evidence: B) "

Sources

• 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease