Mitral regurgitation follow up: Difference between revisions
Jump to navigation
Jump to search
Rim Halaby (talk | contribs) No edit summary |
No edit summary |
||
| (5 intermediate revisions by 2 users not shown) | |||
| Line 9: | Line 9: | ||
==Overview== | ==Overview== | ||
Regular follow up is recommended among patients with asymptomatic mitral regurgitation and preserved [[left ventricular ejection fraction]].<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 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. | journal=Circulation | year= 2014 | volume= 129 | issue= 23 | pages= 2440-92 | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852 }} </ref> | Regular follow up is recommended among patients with asymptomatic mitral regurgitation (MR) and preserved [[left ventricular ejection fraction]].<ref name="pmid24589852">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 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. | journal=Circulation | year= 2014 | volume= 129 | issue= 23 | pages= 2440-92 | pmid=24589852 | doi=10.1161/CIR.0000000000000029 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24589852 }} </ref> | ||
==Follow Up== | ==Follow Up== | ||
| Line 17: | Line 17: | ||
* Severe MR: Every 6-12 months (the frequency increases if the the LV dilatation increases) | * Severe MR: Every 6-12 months (the frequency increases if the the LV dilatation increases) | ||
== 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<ref name="pmid33332150">{{cite journal| author=Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F | display-authors=etal| title=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. | journal=Circulation | year= 2021 | volume= 143 | issue= 5 | pages= e72-e227 | pmid=33332150 | doi=10.1161/CIR.0000000000000923 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33332150 }}</ref> == | |||
=== Recommendations for Diagnostic Testing: Routine Follow-Up for Chronic Primary MR Referenced studies that support the recommendations are summarized in The Online Data Supplement === | |||
{| class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen" |[[ESC guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen" |1. For asymptomatic patients with severe primary MR (Stages B and C1), TTE is indicated every 6 to 12 months for surveillance of LV function (estimated by LVEF, LVEDD, and LVESD) and assessment of pulmonary artery pressure. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' | |||
|} | |||
{| class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LemonChiffon" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | |||
|- | |||
| bgcolor="LemonChiffon" |<nowiki>"</nowiki>'''1.''' Exercise hemodynamics with either [[doppler echocardiography]] or [[cardiac catheterization]] is reasonable in symptomatic patients with chronic primary [[mitral regurgitation]] (MR) where there is a discrepancy between symptoms and the severity of [[MR]] at rest (stages B and C). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki> | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 02:56, 8 December 2022
 |
Resident Survival Guide |
|
Mitral Regurgitation Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Mitral regurgitation follow up On the Web |
|
American Roentgen Ray Society Images of Mitral regurgitation follow up |
|
Risk calculators and risk factors for Mitral regurgitation follow up |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Regular follow up is recommended among patients with asymptomatic mitral regurgitation (MR) and preserved left ventricular ejection fraction.[1]
Follow Up
Echocardiography is performed for follow up among asymptomatic patients with MR to assess the left ventricular ejection fraction (LVEF) and end-systolic dimension. The frequency of follow up with an echocardiogram among asymptomatic patients with MR and normal LVEF is as follows:[1]
- Mild MR: Every 3-5 years
- Moderate MR: Every 1-2 years
- Severe MR: Every 6-12 months (the frequency increases if the the LV dilatation increases)
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[2]
Recommendations for Diagnostic Testing: Routine Follow-Up for Chronic Primary MR Referenced studies that support the recommendations are summarized in The Online Data Supplement
| Class I |
| 1. For asymptomatic patients with severe primary MR (Stages B and C1), TTE is indicated every 6 to 12 months for surveillance of LV function (estimated by LVEF, LVEDD, and LVESD) and assessment of pulmonary artery pressure. (Level of Evidence: B-NR) |
| Class IIa |
| "1. Exercise hemodynamics with either doppler echocardiography or cardiac catheterization is reasonable in symptomatic patients with chronic primary mitral regurgitation (MR) where there is a discrepancy between symptoms and the severity of MR at rest (stages B and C). (Level of Evidence: B-NR) " |
References
- ↑ 1.0 1.1 Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 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". Circulation. 129 (23): 2440–92. doi:10.1161/CIR.0000000000000029. PMID 24589852.
- ↑ Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F; et al. (2021). "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. 143 (5): e72–e227. doi:10.1161/CIR.0000000000000923. PMID 33332150 Check
|pmid=value (help).