Bicuspid aortic stenosis medical therapy: Difference between revisions
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__NOTOC__ | |||
{{Bicuspid aortic stenosis}} | {{Bicuspid aortic stenosis}} | ||
{{CMG}}; {{AOEIC}} {{VK}} | {{CMG}}; {{AOEIC}} {{VK}} | ||
==Overview== | |||
==Medical Therapy== | ==Medical Therapy== | ||
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==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> | ||
==ACC/AHA guidelines for Management of Bicuspid Aortic Valve With Dilated Ascending Aorta<ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS |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=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18820172 |accessdate=2012-04-11}}</ref>== | ==ACC/AHA guidelines for Management of Bicuspid Aortic Valve With Dilated Ascending Aorta<ref name="pmid18820172">{{cite journal |author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS |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=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18820172 |accessdate=2012-04-11}}</ref>== | ||
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It is reasonable to give [[beta-adrenergic blocking agents]] to patients with bicuspid valves and dilated aortic roots (diameter | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
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| 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> | |||
---- | ---- | ||
<NOWIKI>*</NOWIKI>Consider lower threshold values for patients of small stature of either gender. | <NOWIKI>*</NOWIKI>Consider lower threshold values for patients of small stature of either gender. | ||
|} | |||
==References== | ==References== | ||
Revision as of 15:12, 29 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]
Overview
Medical Therapy
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.
For medical therapy of aortic stenosis, click here.
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.[1] However, patients who develop bicuspid aortic stenosis or insufficiency, should avoid strenuous competitive sports.[2]
ACC/AHA guidelines for Management of Bicuspid Aortic Valve With Dilated Ascending Aorta[3]
| 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 C)"
*Consider lower threshold values for patients of small stature of either gender. |
References
- ↑ 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.
- ↑ Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS (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. Retrieved 2012-04-11. Unknown parameter
|month=ignored (help)