Aortic stenosis precautions and prophylaxis

Aortic Stenosis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Aortic Stenosis from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Cardiac Stress Test
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography
Cardiac Catheterization
Aortic Valve Area
Aortic Valve Area Calculation
Treatment
General Approach
Medical Therapy
Surgery
Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty
Transcatheter Aortic Valve Replacement (TAVR) TAVR vs SAVR Critical Pathway Patient Selection Imaging Evaluation Valve Types TAVR Procedure Post TAVR management AHA/ACC Guideline Recommendations
Follow Up
Prevention
Precautions and Prophylaxis
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Aortic stenosis precautions and prophylaxis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Aortic stenosis precautions and prophylaxis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Aortic stenosis precautions and prophylaxis
CDC on Aortic stenosis precautions and prophylaxis
Aortic stenosis precautions and prophylaxis in the news
Blogs on Aortic stenosis precautions and prophylaxis
Directions to Hospitals Treating Aortic stenosis precautions and prophylaxis
Risk calculators and risk factors for Aortic stenosis precautions and prophylaxis

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

Overview

People with aortic stenosis of any etiology are at risk for the development of infection of their stenosed valve, i.e. infective endocarditis and antibiotic prophylaxis should be considered.

Antibiotic Prohylaxis

To reduce the risk of developing infective endocarditis antibiotic prophylaxis should be considered prior to certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of esophageal varices, dilation of esophageal strictures, gastrointestinal surgery where the intestinal mucosa will be disrupted, prostate surgery, urethral stricture dilation, and cystoscopy. Note that routine upper and lower GI endoscopy (i.e. gastroscopy and colonoscopy), with or without biopsy, are not usually considered indications for antibiotic prophylaxis.

Not withstanding the foregoing, the American Heart Association has recently changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007, it is recommended that such prophylaxis be limited only to:

• Those with prosthetic heart valves
• Those with previous episode(s) of endocarditis.
• Those with certain types of congenital heart disease .

Vigorous Exertion

Given the risk of myocardial ischemia and sudden cardiac death, patients with severe aortic stenosis (< 1.0 cm²) should avoid strenuous physical activity including weightlifting and other activities that increase afterload