Valvular Heart Disease

Valvular disease can come to clinical attention due to stenosis, insufficiency (regurgitation/incompetence) or both. Stenosis is the failure of a valve to open completely, which impedes forward flow. Insufficiency results from failure of a valve to close completely, thereby allows reversed flow. Doppler echocardiogram is the best technique for assessing patients with valvular heart disease, but often detects minor, unimportant abnormalities. The clinical consequence of valve dysfunction vary depending on the valve involved, the degree of impairment, the tempo of disease onset, and the rate and quality of compensatory mechanism. Valvular abnormalities can be congenital or acquired

Acquired Heart Valve Disease

Aortic Valve Disease

Mitral Valve Disease

Other Heart Valve Disease

  • Infective Endocarditis
  • Rheumatic Fever

Aortic and mitral valve stenoses account for approximately 2/3 of all valve disease

Summary of Aortic and Mitral valve disease[[

Aortic and Mitral valve pathologies. Can you fill in the blanks? What are the clinical features, tests you would order and treatment options?

Clinical Presentation
Symptoms Signs
Mitral Stenosis Dyspnea, reduced exercise tolerance, productive cough, palpitation, dysphagia (compressed by large left atrium) Palmar erythmea, Malar flush, tapping apex beat
Mitral Regurgitation Acute dyspnea and pulmonary congestion Signs of Left-sided heart failure in late stages
Aortic stenosis Exertional Syncope, Dyspnea and angina Pulsus tradeus et parvus, narrow pulse pressure, sustained and powerful apex beat.
Aortic regurgitation Similar t[[[o aortic stenosis Waterhammer pulse, wide pulse pressure
Clinical Auscultation
Murmur Heart Sound
Mitral Stenosis High pitched early-diastolic murmur Loud S1
Mitral Regurgitation Pansystolic murmur radiates to the axilla Soft S1 loud S2
Aortic stenosis Ejection systolic "crescendo decresendo" murmur radiating to the carotids Soft S2
Aortic regurgitation Early diastolic murmur Soft S2