Aortic stenosis precautions and prophylaxis: Difference between revisions
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==Overview== | ==Overview== | ||
Aortic stenosis of any etiology is associated with a higher rate of infection of the stenosed valve, i.e. [[infective endocarditis]]. | Aortic stenosis of any etiology is associated with a higher rate of infection of the stenosed valve, i.e. [[infective endocarditis]]. The American Heart Association recommended that prophylaxis against [[infective endocarditis]] be limited only to patients with either [[prosthetic heart valves]], previous episode(s) of [[endocarditis]], or with certain types of [[congenital heart disease]]. Patients with severe aortic stenosis should avoid strenuous exercise and any exercise that greatly increases [[afterload]] such as weight lifting. | ||
==Antibiotic Prophylaxis== | ==Antibiotic Prophylaxis== | ||
Revision as of 20:05, 18 December 2019
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Resident Survival Guide |
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Aortic Stenosis Microchapters |
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Diagnosis |
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Treatment |
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Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty |
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Transcatheter Aortic Valve Replacement (TAVR) |
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Case Studies |
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Aortic stenosis precautions and prophylaxis On the Web |
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American Roentgen Ray Society Images of Aortic stenosis precautions and prophylaxis |
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Directions to Hospitals Treating Aortic stenosis precautions and prophylaxis |
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Risk calculators and risk factors for Aortic stenosis precautions and prophylaxis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Aortic stenosis of any etiology is associated with a higher rate of infection of the stenosed valve, i.e. infective endocarditis. The American Heart Association recommended that prophylaxis against infective endocarditis be limited only to patients with either prosthetic heart valves, previous episode(s) of endocarditis, or with certain types of congenital heart disease. Patients with severe aortic stenosis should avoid strenuous exercise and any exercise that greatly increases afterload such as weight lifting.
Antibiotic Prophylaxis
Aortic stenosis of any etiology is associated with a higher rate of infection of the stenosed valve, i.e. infective endocarditis.[1] To reduce the risk of developing infective endocarditis among high-risk patients, antibiotic prophylaxis should be considered prior to certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of esophageal varices, dilation of esophageal strictures, gastrointestinal surgery where the intestinal mucosa will be disrupted, prostate surgery, urethral stricture dilation, and cystoscopy. Note that routine upper and lower GI endoscopy (i.e. gastroscopy and colonoscopy), with or without biopsy, are not usually considered indications for antibiotic prophylaxis.
Not withstanding the foregoing, the American Heart Association has recently changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007, it is recommended that such prophylaxis be limited only to:
- Those with prosthetic heart valves
- Those with previous episode(s) of endocarditis
- Those with certain types of congenital heart disease [2]
Vigorous Exertion
Given the risk of myocardial ischemia and sudden cardiac death, patients with severe aortic stenosis (< 1.0 cm2) should avoid strenuous physical activity including weightlifting and other activities that increase afterload.
References
- ↑ Michel PL, Acar J (1995). "Native cardiac disease predisposing to infective endocarditis". Eur Heart J. 16 Suppl B: 2–6. PMID 7671919.
- ↑ "www.heart.org". Retrieved 2013-01-09.