Valvular heart disease

Question 1

Definition

Answer 1

Umbrella term for disease that causes damage to one of the heart’s valves

Most common is Aortic stenosis

Can include mitral incompetence & stenosis

Question 2

Aetiology/ causes

Answer 2

Age-related calcification

Congenital malformation (congenital heart valve disease)

Previous rheumatic fever
Cardiomyopathy - a disease of the heart muscle
Damage to the heart muscle from a heart attack
Previous infection with endocarditis

Question 3

Risk factors

Answer 3

History of certain infections that can affect the heart

History of certain forms of heart disease or heart attack

High blood pressure, high cholesterol, diabetes and other heart disease risk factors

Heart conditions present at birth (congenital heart disease)

Question 4

Epidemiology/ Population affected

Answer 4

Older age more commonly affected (5th to 8th decades)

Question 5

Clinical presentation

Answer 5

Breathlessness
Feeling weak or dizzy
Discomfort in your chest
Swollen ankles and feet
Being unusually tired
Palpitations

Can cause angina, syncope, left ventricular failure or sudden death

Question 6

Prognosis

Answer 6

Asymptomatic patients who do not progress to symptomatic have a longer life expectancy. Prognosis of patients with severe symptomatic aortic valve disease who do not undergo valve replacement is very poor, with survival at 3 years ranging from approximately 40 to 60%, whereas those who underwent valve replacement ranged from 80 to 90%

Question 7

DDX

Answer 7

Hypertrophic obstructive cardiomyopathy
Restrictive cardiomyopathy
Constrictive cardiomyopathy

Congestive heart failure with reduced ejection fraction (HFrEF)

Coronary artery disease
Atrial fibrillation/ Atrial flutter
Ischaemic heart disease
Pericardial effusion
Pulmonary hypertension
Chronic obstructive pulmonary disease
Restrictive lung diseases
Symptomatic anemia