Bicuspid aortic stenosis medical therapy: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
Usama Talib (talk | contribs) No edit summary |
||
| (8 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Bicuspid aortic stenosis}} | {{Bicuspid aortic stenosis}} | ||
{{CMG}}; {{AOEIC}} {{VK}} | {{CMG}}; {{AOEIC}} {{VK}}; {{USAMA}} | ||
'''For medical therapy of aortic stenosis, click [[Aortic stenosis medical therapy|here]].''' | '''For medical therapy of aortic stenosis, click [[Aortic stenosis medical therapy|here]].''' | ||
==Overview== | ==Overview== | ||
There is no specific medical treatment for patients with bicuspid aortic valves. However, the patients should be followed-up regularly to evaluate the progress and early recognition of complications such as valve [[aortic insufficiency|insufficiency]], stenosis, progressive aortic root dilation, [[aortic aneurysm|aneurysm]], [[aortic dissection|dissection]] and prevention of possible [[endocarditis]]. Since high [[lipid]] levels may accelerate the [[calcification]] of a congenital bicuspid aortic valve, a heart-healthy diet is recommended for all patients. | There is no specific medical treatment for patients with bicuspid aortic valves. However, the patients should be followed-up regularly to evaluate the progress and early recognition of complications such as valve [[aortic insufficiency|insufficiency]], stenosis, progressive aortic root dilation, [[aortic aneurysm|aneurysm]], [[aortic dissection|dissection]] and prevention of possible [[endocarditis]]. Since high [[lipid]] levels may accelerate the [[calcification]] of a congenital bicuspid aortic valve, a heart-healthy diet is recommended for all patients.<ref>{{Cite web | last = | first = | title = 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary | url = http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000029.full.pdf+html | publisher = | date = | accessdate = 4 March 2014 }}</ref><ref>{{Cite web | last = | first = | title = 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary | url = http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000029.full.pdf+html | publisher = | date = | accessdate = 4 March 2014 }}</ref><ref>{{Cite web | last = | first = | title = 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary | url = http://circ.ahajournals.org/content/early/2014/02/27/CIR.0000000000000029.full.pdf+html | publisher = | date = | accessdate = 4 March 2014 }}</ref> | ||
==Physical Activity== | ==Physical Activity== | ||
Patients with normally functioning bicuspid aortic valve have no restrictions for any kind of activities after ruling out other pathologic conditions of aorta.<ref name="pmid17548371">{{cite journal |author=Stefani L, Galanti G, Toncelli L, Manetti P, Vono MC, Rizzo M, Maffulli N |title=Bicuspid aortic valve in competitive athletes |journal=[[British Journal of Sports Medicine]] |volume=42 |issue=1 |pages=31–5; discussion 35 |year=2008 |month=January |pmid=17548371 |doi=10.1136/bjsm.2006.033530 |url=http://bjsm.bmj.com/cgi/pmidlookup?view=long&pmid=17548371 |accessdate=2012-04-11}}</ref> However, patients who develop bicuspid aortic stenosis or insufficiency, should avoid strenuous competitive sports.<ref name="pmid18296454">{{cite journal |author=De Mozzi P, Longo UG, Galanti G, Maffulli N |title=Bicuspid aortic valve: a literature review and its impact on sport activity |journal=[[British Medical Bulletin]] |volume=85 |issue= |pages=63–85 |year=2008 |pmid=18296454 |doi=10.1093/bmb/ldn002 |url=http://bmb.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18296454 |accessdate=2012-04-11}}</ref> | Patients with normally functioning bicuspid aortic valve have no restrictions for any kind of activities after ruling out other pathologic conditions of aorta.<ref name="pmid17548371">{{cite journal |author=Stefani L, Galanti G, Toncelli L, Manetti P, Vono MC, Rizzo M, Maffulli N |title=Bicuspid aortic valve in competitive athletes |journal=[[British Journal of Sports Medicine]] |volume=42 |issue=1 |pages=31–5; discussion 35 |year=2008 |month=January |pmid=17548371 |doi=10.1136/bjsm.2006.033530 |url=http://bjsm.bmj.com/cgi/pmidlookup?view=long&pmid=17548371 |accessdate=2012-04-11}}</ref> However, patients who develop bicuspid aortic stenosis or insufficiency, should avoid strenuous competitive sports.<ref name="pmid18296454">{{cite journal |author=De Mozzi P, Longo UG, Galanti G, Maffulli N |title=Bicuspid aortic valve: a literature review and its impact on sport activity |journal=[[British Medical Bulletin]] |volume=85 |issue= |pages=63–85 |year=2008 |pmid=18296454 |doi=10.1093/bmb/ldn002 |url=http://bmb.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=18296454 |accessdate=2012-04-11}}</ref> | ||
==2008 ACC/AHA | ==2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=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 |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>== | ||
===Bicuspid Aortic Valve With Dilated Ascending Aorta (DO NOT EDIT) <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=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 |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref>=== | |||
{|class="wikitable" | {|class="wikitable" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to give [[beta-adrenergic blocking agents]] to patients with bicuspid valves and dilated aortic roots (diameter greater than 4.0 cm*) who are not candidates for surgical correction and who do not have moderate to severe [[AR]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to give [[beta-adrenergic blocking agents]] to patients with bicuspid valves and dilated [[aortic roots]] (diameter greater than 4.0 cm*) who are not candidates for surgical correction and who do not have moderate to severe [[AR]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|''Level of Evidence: C'']])<nowiki>"</nowiki> | ||
|} | |} | ||
{{cquote| <NOWIKI>*</NOWIKI> Consider lower threshold values for patients of small stature of either gender. }} | |||
==Sources== | |||
*2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease <ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, ''et al.'' |title=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 |journal=Circulation |volume=118 |issue=15 |pages=e523–661 |year=2008 |month=October |pmid=18820172 |doi=10.1161/CIRCULATIONAHA.108.190748 |url=}}</ref> | |||
==References== | ==References== | ||
| Line 26: | Line 32: | ||
{{WS}} | {{WS}} | ||
{{WH}} | {{WH}} | ||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Latest revision as of 15:56, 5 January 2017
|
Bicuspid aortic stenosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Bicuspid aortic stenosis medical therapy On the Web |
|
American Roentgen Ray Society Images of Bicuspid aortic stenosis medical therapy |
|
Risk calculators and risk factors for Bicuspid aortic stenosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; Usama Talib, BSc, MD [3]
For medical therapy of aortic stenosis, click here.
Overview
There is no specific medical treatment for patients with bicuspid aortic valves. However, the patients should be followed-up regularly to evaluate the progress and early recognition of complications such as valve insufficiency, stenosis, progressive aortic root dilation, aneurysm, dissection and prevention of possible endocarditis. Since high lipid levels may accelerate the calcification of a congenital bicuspid aortic valve, a heart-healthy diet is recommended for all patients.[1][2][3]
Physical Activity
Patients with normally functioning bicuspid aortic valve have no restrictions for any kind of activities after ruling out other pathologic conditions of aorta.[4] However, patients who develop bicuspid aortic stenosis or insufficiency, should avoid strenuous competitive sports.[5]
2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) [6]
Bicuspid Aortic Valve With Dilated Ascending Aorta (DO NOT EDIT) [6]
| Class IIa |
| "1. It is reasonable to give beta-adrenergic blocking agents to patients with bicuspid valves and dilated aortic roots (diameter greater than 4.0 cm*) who are not candidates for surgical correction and who do not have moderate to severe AR. (Level of Evidence: C)" |
| “ | * Consider lower threshold values for patients of small stature of either gender. | ” |
Sources
- 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease [6]
References
- ↑ "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
- ↑ "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
- ↑ "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
- ↑ Stefani L, Galanti G, Toncelli L, Manetti P, Vono MC, Rizzo M, Maffulli N (2008). "Bicuspid aortic valve in competitive athletes". British Journal of Sports Medicine. 42 (1): 31–5, discussion 35. doi:10.1136/bjsm.2006.033530. PMID 17548371. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help) - ↑ De Mozzi P, Longo UG, Galanti G, Maffulli N (2008). "Bicuspid aortic valve: a literature review and its impact on sport activity". British Medical Bulletin. 85: 63–85. doi:10.1093/bmb/ldn002. PMID 18296454. Retrieved 2012-04-11.
- ↑ 6.0 6.1 6.2 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "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. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
|month=ignored (help)