Valvular Heart Disease
Severe valvular disease is identified as a potential “active cardiac condition” in the American College of Cardiology/American Heart Association (ACC/AHA) perioperative guidelines, requiring evaluation and management prior to noncardiac surgery. Attention to the type and severity of valvular heart disease during the preoperative visit can help guide perioperative risk assessment and management. Severe aortic stenosis and mitral stenosis are considered to pose the greatest perioperative risk. Distinguishing pathologic from functional murmurs and assessing a patient’s functional status by careful history and exam are the first essential steps. An echocardiogram should be obtained preoperatively if symptoms or exam are concerning for severe valvular disease.
Perioperative considerations in patients with other structural heart conditions, such as congenital cyanotic heart disease, are beyond the scope of this book—the patient’s cardiologist should generally be involved in the care of these patients.
KeywordsAortic Stenosis Mitral Regurgitation Aortic Regurgitation Mitral Stenosis Mitral Valve Prolapse
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