Presentation
A rationalisation of the 1350 boxes used throughout the book gives a simpler and clearer presentation of the various categories. [books.google.de]
Three patients presented mild tricuspid stenosis and one patient had moderate tricuspid stenosis. Two patients presented with mild pulmonary regurgitation and one patient presented with severe insufficiency. [ncbi.nlm.nih.gov]
Dobutamine stress echocardiography can help determine if truly severe aortic stenosis is present (with a falsly low gradient) or if mild/moderate aortic stenosis is present. [healio.com]
The chest pain increases with exercise and eases with rest, and is present under the chest bone - although it may move to other areas of the chest. [disabled-world.com]
A 67-year-old female patient of North African origin, with a history of rheumatic fever during childhood, presented with exertion dyspnoea. [academic.oup.com]
Entire Body System
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Physician
The ICD-10-CM for Physicians & Hospitals 2018 is brimming with new and revised ICD-10-CM codes and their descriptors, along with expert guidance and the vital features you need for correct coding and reimbursement. [books.google.de]
All airlines have physician consultants and this might require the patient's physician talking directly with the airline's physician. [cnn.com]
Search Physicians View All Physicians Your Visit Your Visit We want your visit to go smoothly. [heart.phoenixchildrens.org]
Employees Volunteer Services Philanthropy Contact Us Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician [wakehealthse3.adam.com]
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Hunting
DOI: 10.1016/j.jacc.2008.05.007 PubMed ID: 18848134 HubMed Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, Del Nido P, Fasules JW, Graham TP Jr, Hijazi ZM, Hunt SA, King ME, Landzberg MJ, Miner PD, Radford MJ, Walsh EP, and Webb [textbookofcardiology.org]
Cardiovascular
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Heart Disease
disease I249Acute ischemic heart disease, unspecified I255Ischemic cardiomyopathy I256Silent myocardial ischemia I2589Other forms of chronic ischemic heart disease I259Chronic ischemic heart disease, unspecified I878Other specified disorders of veins [cms.gov]
Many valvular heart diseases can be treated with medication, or surgery and other procedures to repair or replace the valve. Types of valvular heart disease 1. [heartandstroke.ca]
The Changing Burden of Valvular Heart Disease 07 June 2012 BCS Editorial By: Aneil Malhotra Oxford Deanery Introduction Valvular heart disease (VHD) was historically caused by rheumatic heart disease and this remains a major burden in developing countries [bcs.com]
Still, in developing countries, rheumatic heart disease remains the most common cause of valvular heart disease. [textbookofcardiology.org]
disease · 398.0 Rheumatic myocarditis · Rheumatic degeneration of myocardium · Excludes: myocarditis not specified as rheumatic (429.0) · 398.9 Other and unspecified rheumatic heart diseases · 398.90 Rheumatic heart disease, unspecified · Rheumatic: [cairdtech.com]
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Heart Murmur
The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope. But many people have heart murmurs without having a problem. [icdlist.com]
They will listen to the person's heart with a stethoscope, listening for a heart murmur, click, or any other form of abnormal sound. [disabled-world.com]
A heart murmur, click, or other abnormal sound is almost always heard through a stethoscope. The provider may be able to feel a vibration or movement when placing a hand over the heart. [medlineplus.gov]
This is known as a heart murmur. It often indicates valve trouble, but not always. Continued After a full exam and a review of your medical history, your doctor may order a few tests. [webmd.com]
Patients with moderate to severe obstruction may have bluish discoloration of the skin, breathing difficulties, chest pain, fatigue, and heart murmur When treatment is necessary, the condition is treated either with balloon valvuloplasty or an open heart [dovemed.com]
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Mitral Valve Prolapse
Lifetime risk for patients with mitral valve prolapse of developing severe valve regurgitation requiring surgery. Circulation 1998;78:10-14. [my.clevelandclinic.org]
Cases of mitral valve prolapse were divided into 4 subgroups : rupture of chordae tendinea (15), absence of chordae (7) (complicated with chordal rupture), looping chordae (5) and idiopathic mitral valve prolapse (4). [ci.nii.ac.jp]
Mitral valve prolapse In mitral valve prolapse, the valve fails to close evenly. Part or all of the mitral valve bulges upward into the atrium when the two ventricles contracts. [heartandstroke.ca]
If they don't, you could have Regurgitation - when blood leaks back through the valve in the wrong direction Mitral valve prolapse - when one of the valves, the mitral valve, has "floppy" flaps and doesn't close tightly. [icdlist.com]
Most commonly affecting the mitral valve, it is a progressive process that represents slow degeneration from mitral valve prolapse (improper leaflet movement), a condition that affects 4-5 percent of the general population. [yourheartvalve.com]
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Systolic Murmur
Ejection systolic murmur in aortic stenosis is preceded by a click and is best heard over the right upper sternal border, radiating into the suprasternal region and neck. [link.springer.com]
murmur that is heard on praecordial auscultation 1,2. [radiopaedia.org]
Does this patient have an abnormal systolic murmur?. JAMA. 1997 Feb 19. 277(7):564-71. [Medline]. Leach RM, McBrien DJ. Brachioradial delay: a new clinical indicator of the severity of aortic stenosis. Lancet. 1990 May 19. 335(8699):1199-201. [emedicine.medscape.com]
On admission, he was apyretic, and cardiac auscultation revealed metallic heart sounds from the prosthetic valves and a systolic murmur of varying intensity throughout the precordium. [revportcardiol.org]
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Narrow Pulse Pressure
Clinical examination classically reveals a narrow pulse pressure, a slow-rising peripheral pulse, pulsus parvus et tardus (weak and delayed pulse) in the carotid pulse, a pressure loaded ('heaving') apex beat, and a crescendo-decrescendo mid-systolic [radiopaedia.org]
pulse pressure Electrocardiogram [ edit ] Although aortic stenosis does not lead to any specific findings on the electrocardiogram (ECG), it still often leads to a number of electrocardiographic abnormalities. [en.wikipedia.org]
Psychiatrical
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Denial
Rely on TCI and avoid unspecified code denials once and for all. [books.google.de]
Neurologic
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Dizziness
They are decreased exercise tolerance, shortness of breath and fatigue -- all symptoms of chronic heart failure -- as well as dizziness, fainting, and chest pain. Once symptoms develop, even if they are mild, the AS is considered severe. [cnn.com]
The person can experience weakness, fainting, or dizziness with activity, or palpitations of their heart. Infants and children can experience symptoms such as fatigue, or becoming tired more easily than others. [disabled-world.com]
Fainting, weakness, or dizziness with activity. [medlineplus.gov]
Fainting, dizziness or tiredness. If the amount of blood getting through to the ventricle is reduced, the output of blood from the left ventricle to the body is then reduced. Chest pains (angina). [patient.info]
Symptoms may include: Fatigue Dizziness with exertion Shortness of breath Irregular heartbeats or palpitations Chest pain The symptoms of aortic stenosis may look like other medical conditions or heart problems. [stanfordchildrens.org]
Workup
Laboratory workup showed no inflammatory markers. Autoimmunity tests were all negative. A computed tomography angiography was performed in order to visualize the aorta, the main arteries ( Panel D ) and the valves ( Panel E ). [academic.oup.com]
Two-dimensional (2D) Doppler echocardiography is the imaging modality of choice to diagnose and estimate the severity of aortic stenosis and localize the level of obstruction (see Workup ). [emedicine.medscape.com]
Hypertrophy
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Left Ventricular Hypertrophy
In people with LVH, this PMI can actually move medially, or towards the sternum, and that would be a sign of left ventricular hypertrophy, meaning the muscle has kind of gotten thicker. [khanacademy.org]
A S4 heart sound is also often present due to the severe concentric left ventricular hypertrophy that develops in aortic stenosis. [healio.com]
This gradient may progressively increase without any significant changes to left ventricular function because of compensatory left ventricular hypertrophy, appreciated clinically by the pressure loaded apex beat 1,2. [radiopaedia.org]
The classic triad of symptoms of significant aortic stenosis: (EFFORT ASD) (a) Effort A ngina (b) Effort S yncope (c) Effort D yspnoea (and Fatigue) Concentric left ventricular hypertrophy is an independent risk factor for operative mortality at aortic [cthsurgery.com]
Angina in the setting of AS occurs due to left ventricular hypertrophy (LVH) that is caused by the constant production of increased pressure required to overcome the pressure gradient caused by the AS. [en.wikipedia.org]
Treatment
Conversely, even if no symptoms are present, it may be advisable to proceed with treatment or repairs based on the test results. Possible treatments may include valve repair or valve replacement. [heart.org]
Medical mild cases: prophylaxis against SBE moderate: above plus treatment of LVF. [aic.cuhk.edu.hk]
Medications and surgery are the two possible treatment options for aortic valve disease. Your doctor would recommend appropriate treatment depending on the condition. [gleneaglesglobalhospitals.com]
People with aortic stenosis should receive treatment for high cholesterol and quit smoking. They should also see a cardiologist every three-to-six months. [disabled-world.com]
Men with MVP are more likely than women to require surgical treatment, and the need for surgery increases with age. Overall, 60 percent of people with MVP will not require treatment. [my.clevelandclinic.org]
Prognosis
prognosis, and additional useful information HERE. [dovemed.com]
Congestive heart failure [ edit ] Congestive heart failure (CHF) carries a grave prognosis in people with AS. [en.wikipedia.org]
LAD and/or QRS prolongation suggest diffuse myocardial disease, generally associated with patchy fibrosis, and usually indicate a poor prognosis CXR: LV dilatation, pulmonary venous hypertension. [aic.cuhk.edu.hk]
Paradoxical low-flow aortic stenosis may often be misdiagnosed, leading to an underestimation of symptoms and an inappropriate delay of aortic valve replacement surgery, without which the patients' prognosis is poor [5]. [wikiecho.org]
Failure to normally increase BP and development of ST segment depression are less predictive of adverse prognosis. Exercise testing is contraindicated in symptomatic patients. [merckmanuals.com]
Etiology
Over the past 60 years, the etiology of most valvular heart diseases in industrialized countries shifted towards degenerative etiologies, mainly because of a decrease in acute rheumatic fever. [textbookofcardiology.org]
Classification and etiology There are numerous other predisposing factors and causes of aortic stenosis. [radiopaedia.org]
Increased LA pressure - Pulm HTN - RV Pressure Overload - RV failure & Tricuspid Regurgitation Etiology: Rheumatic Heart Disease Symptoms: Dyspnea, Orthopnea, PND Cough & Hemoptysis Atrial Fibrillation, LA thrombus and systemic Embolization RV failure [brown.edu]
[…] ses ) an abnormal narrowing or contraction of a body passage or opening; called also arctation, coarctation, and stricture. aortic stenosis obstruction to the outflow of blood from the left ventricle into the aorta; in the majority of adult cases the etiology [medical-dictionary.thefreedictionary.com]
The etiology of pannus has yet to be fully clarified, 2 but is probably multifactorial. [revportcardiol.org]
Epidemiology
Pulmonary/ Tricuspid Valve Disease The elderly population rarely presents with primary disease of these valves and there are no meaningful epidemiological data available. [bcs.com]
Epidemiology Most common cause of LV outflow obstruction in both children and adults Predominant age 30 to 65 years: congenital or rheumatic fever (RF) 65 years: degenerative calcification of aortic valve Prevalence Affects 1.3% of population 65 to 74 [unboundmedicine.com]
Aortic stenosis Epidemiology tends to present in fith to seventh decades 80% of patients with severe aortic stenosis are men Aetiology congenital: may lead to stenosis as birth or aortic stenosis may develop in later life due to haemodynamic stresses [aic.cuhk.edu.hk]
Clinical and epidemiological characteristics of the study population are shown in Table 1. Table 1 Clinical and epidemiological characteristics of the study population. Salvador, 2007-2011. [ncbi.nlm.nih.gov]
Epidemiology Valvular heart diseases are a major burden to society and it is expected that the prevalence will increase. Rheumatic valve disease used to be the most prevalent etiology of valvular cardiac diseases worldwide. [textbookofcardiology.org]
Pathophysiology
Figure 3 -- Pathophysiology of acute and chronic mitral regurgitation Fig 3: Pathophysiology of mitral regurgitation. [brown.edu]
Etiology and Pathophysiology Progressive aortic leaflet thickening and calcification results in LV outflow obstruction. Obstruction causes increased afterload and, over time, decreased cardiac output. [unboundmedicine.com]
Pathophysiology of Heart Disease (3rd ed.). Lippincott Williams & Wilkins. ISBN 0-7817-4027-4. G. Morris, Innasimuthu A L, J.P. Fox, R.A. [en.wikipedia.org]
"Pathophysiology of Aortic Valve Disease." Cardiac Surgery in the Adult. Ed. Cohn L.H. Third Edition ed. McGraw-Hill Education, 2012. 825-40. [textbookofcardiology.org]
Aetiology congenital: may lead to stenosis as birth or aortic stenosis may develop in later life due to haemodynamic stresses on congenital bicuspid valve rheumatic heart disease idiopathic valve calcification: rarely leads to significant aortic stenosis Pathophysiology [aic.cuhk.edu.hk]
Prevention
Like valves used in house plumbing, the heart valves open to allow fluid (blood) to be pumped forward, and they close to prevent fluid from flowing backward. Human heart valves are flaps of tissue called leaflets or cusps. [health.harvard.edu]
In the normal heart, left ventricular (LV) contraction during systole forces blood exclusively through the aortic valve into the aorta; the closed mitral valve prevents regurgitation into the left atrium (LA). [brown.edu]
The possible impact of secondary prevention measures, particularly lipid lowering with statins, on the progression of aortic stenosis has been investigated. [columbiasurgery.org]
The structures supporting the heart valves weaken and stretch over time and this prevents the valves from closing properly. [patient.info]
Your child's cardiologist may recommend that antibiotics be given to prevent bacterial endocarditis after discharge from the hospital. [stanfordchildrens.org]