Valvular heart disease primary prevention: Difference between revisions

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:* Patients who have hypertrophic cardiomyopathy when there is latent or resting obstruction. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients who have hypertrophic cardiomyopathy when there is latent or resting obstruction. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients with MVP and auscultatory evidence of valvular regurgitation and/or thickened leaflets on echocardiography. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) <nowiki>"</nowiki>
:* Patients with MVP and auscultatory evidence of valvular regurgitation and/or thickened leaflets on echocardiography. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) <nowiki>"</nowiki>
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{|class="wikitable"
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|colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (Harm)
|-
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Prophylaxis against infective endocarditis is not recommended for the following patients:
:* Patients with isolated secundum atrial septal defect. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients 6 or more months after successful surgical or percutaneous repair of atrial septal defect, ventricular septal defect, or patent ductus arteriosus. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients with MVP without MR or thickened leaflets on echocardiography. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients with physiological, functional, or innocent heart murmurs, including patients with aortic valve sclerosis as defined by focal areas of increased echogenicity
:** and thickening of the leaflets without restriction of motion and a peak velocity less than 2.0 m per second. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients with echocardiographic evidence of physiologic MR in the absence of a murmur and with structurally normal valves. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])
:* Patients with echocardiographic evidence of physiological TR and/or pulmonary regurgitation in the absence of a murmur and with structurally normal valves. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) <nowiki>"</nowiki>
|}
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Revision as of 15:37, 22 October 2012

Valvular heart disease Microchapters

Patient Information

Classification

Aortic stenosis
Aortic regurgitation
Mitral stenosis
Mitral valve prolapse
Mitral regurgitation
Tricuspid stenosis
Tricuspid regurgitation
Pulmonary stenosis
Pulmonary regurgitation

Differential Diagnosis

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

2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease - Endocarditis and Rheumatic Fever Prophylaxis (DO NOT EDIT) [1]

Recommendations for Endocarditis Prophylaxis

Class I
"1. Prophylaxis against infective endocarditis is recommended for the following patients:
  • Patients with prosthetic heart valves and patients with a history of infective endocarditis. (Level of Evidence: C)
  • Patients who have complex cyanotic congenital heart disease (e.g., single-ventricle states, transposition of the great arteries, tetralogy of Fallot). (Level of Evidence: C)
  • Patients with surgically constructed systemic pulmonary shunts or conduits. (Level of Evidence: C)
  • Patients with congenital cardiac valve malformations, particularly those with bicuspid aortic valves, and patients with acquired valvular dysfunction (e.g., rheumatic heart disease).(Level of Evidence: C)
  • Patients who have undergone valve repair. (Level of Evidence: C)
  • Patients who have hypertrophic cardiomyopathy when there is latent or resting obstruction. (Level of Evidence: C)
  • Patients with MVP and auscultatory evidence of valvular regurgitation and/or thickened leaflets on echocardiography. (Level of Evidence: C) "
Class III (Harm)
"1. Prophylaxis against infective endocarditis is not recommended for the following patients:
  • Patients with isolated secundum atrial septal defect. (Level of Evidence: C)
  • Patients 6 or more months after successful surgical or percutaneous repair of atrial septal defect, ventricular septal defect, or patent ductus arteriosus. (Level of Evidence: C)
  • Patients with MVP without MR or thickened leaflets on echocardiography. (Level of Evidence: C)
  • Patients with physiological, functional, or innocent heart murmurs, including patients with aortic valve sclerosis as defined by focal areas of increased echogenicity
    • and thickening of the leaflets without restriction of motion and a peak velocity less than 2.0 m per second. (Level of Evidence: C)
  • Patients with echocardiographic evidence of physiologic MR in the absence of a murmur and with structurally normal valves. (Level of Evidence: C)
  • Patients with echocardiographic evidence of physiological TR and/or pulmonary regurgitation in the absence of a murmur and with structurally normal valves. (Level of Evidence: C) "

References

  1. ↑ Bonow RO, Carabello BA, Kanu C; et al. (2006). "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): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons". Circulation. 114 (5): e84–231. doi:10.1161/CIRCULATIONAHA.106.176857. PMID 16880336. Unknown parameter |month= ignored (help)
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