Key Points
Î Patients with VHD may present with a heart murmur, symptoms,
or incidental findings of valvular abnormalities on noninvasive
testing.
Î The initial evaluation should include a detailed history
and physical exam, ECG, chest x-ray, and transthoracic
echocardiogram.
Î Decisions about treatment are based primarily on the presence
or absence of symptoms, severity of VHD, and response of the
ventricle to pressure or volume overload imposed by VHD.
Î VHD requires a multidisciplinary team and approach for its
diagnosis and management.
Î Reasons for valve intervention are to improve symptoms, prolong
survival, and reduce the risk of complications.
Î An evaluation of the surgical or interventional risk for each
individual patient should be performed if intervention is indicated
which includes a standard surgical risk score, along with
consideration of comorbidites, frailty, and procedure specfic
impediments.
Î Follow-up of patients with VHD is important to assess symptom
status, provide patient education, and monitor disease severity,
typically with periodic echocardiography.
