Native Valve Regurgitation in Pregnancy: Difference between revisions

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===Medical Therapy===
===Medical Therapy===
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| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
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| bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' ACE inhibitors and ARBs should not be given to pregnant patients with valve regurgitation  ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
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===Intervention===
===Intervention===



Revision as of 22:02, 27 October 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Native Valve Regurgitation in Pregnancy[1]

Diagnosis and Follow-up

Class I
"1. All patients with suspected valve regurgitation should undergo a clinical evaluation and TTE before pregnancy.(Level of Evidence: C)"
"2. All patients with severe valve regurgitation (stages C and D) should undergo prepregnancy counseling by a cardiologist with expertise in managing patients with VHD during pregnancy.(Level of Evidence: C)"
"3. All patients referred for a valve operation before pregnancy should receive prepregnancy counseling by a cardiologist with expertise in managing patients with VHD during pregnancy regarding the risks and benefits of all options for operative interventions, including mechanical prosthesis, bioprosthesis, and valve repair.(Level of Evidence: C)"
"4. Pregnant patients with severe regurgitation (stages C and D) should be monitored in a tertiary care center with a dedicated Heart Valve Team of cardiologists, surgeons, anesthesiologists, and obstetricians with expertise in managing high-risk cardiac patients.(Level of Evidence: C)"
Class IIa
"1. Exercise testing is reasonable in asymptomatic patients with severe valve regurgitation (stage C) before pregnancy.(Level of Evidence: C)"

Medical Therapy

Class III (Harm)
"1. ACE inhibitors and ARBs should not be given to pregnant patients with valve regurgitation (Level of Evidence: B)"

Intervention

References

  1. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O'Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM, Thomas JD (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". J. Am. Coll. Cardiol. 63 (22): 2438–88. doi:10.1016/j.jacc.2014.02.537. PMID 24603192.

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