conclusions with a thorough preoperative assessment incorporating focused echocardiography, anaesthetists are in the unique position to enhance their role as perioperative physicians and influence short and long term outcomes of their patients. context patients with undifferentiated systolic murmurs present commonly during the perioperative period. traditional bedside assessment and auscultatio...

Percutaneous Mitral Commissurotomy Rheumatic mitral stenosis continues to be endemic in developing countries, where mitral stenosis is the most frequent valve disease.1 Although the prevalence of rheumatic fever has greatly decreased in Western countries, it continues to represent an important clinical entity because of outmigration from developing countries. The figure given by the registry Eu...

For patients with stenotic native valves, the modified Bernoulli equation (AIP = 4v2) may be applied to Doppler-measured transvalvular velocities to yield an accurate estimate of transvalvular gradients. Although it would be useful if the same approach could be used for those with stenotic prosthetic valves, no previous study has validated the Doppler technique in this setting. We therefore rec...

R adiation therapy has been a mainstay for treating lymphomas and can be curative in some lymphomas such as Hodgkin’s disease. Long term follow-up studies have shown progressive valvular heart disease in some patients, especially those with mediastinal radiation that includes the heart. In addition, these studies have observed that chemotherapy, particularly with anthracyclines, seemed to incre...

Empirical evidence regarding the association between antidepressants and valvular heart disease (VHD) is scarce.Using Taiwan's National Health Insurance Research database, this nested case-control study assessed the association between antidepressants and VHD in a Chinese population.Among a cohort of patients who used at least 3 prescription antidepressants, 874 cases with VHD and 3496 matched ...

Over the past 25 to 30 years advances in therapeutics and pathology have considerably modified traditional concepts of valve disease, band much of the earlier literature of cardiac pathology has become mainly of historic interest. The introduction of antibiotics changed the pathology and course of infective endocarditis and is reducing the incidence of chronic rheumatic and syphilitic valve dis...

disease due to congenital or acquired etiologies in pregnant patients can be challenging. There is an elevated incidence of adverse maternal and fetal outcomes in this patient population. The keys to optimizing pregnancy outcomes are accurate diagnosis of the etiology and severity of valve disease, pre-conception evaluation and counseling, and referral of the highest risk women to centers with ...

The cardiac valves have as their function the maintenance of unidirectional flow, to ensure that the energy released during myocardial contraction is transformed efficiently into the circulation of blood around the body. When the valves become diseased, compensatory mechanisms are brought into play to maintain the circulation commensurate with the metabolic needs of the body. These mechanisms, ...

Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Echocardiography has become the primary non-invasive imaging method for the evaluation of valvular regurgitation. The echocardiographic assessment of valvular regurgitation should integrate quantification of the regurgitation, assessment of the valve anatomy, and function as well as the consequences ...

Symptom development represents one of the most important indications for surgical intervention in patients with significant valvular heart disease. Exercise testing has an established role in the assessment of exercise capacity and symptomatic status in patients with severe valvular heart disease who claim to be asymptomatic. In these patients, clinical decision can be influenced by the results...