Valvular heart disease
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2]
Valvular heart disease Microchapters |
Overview
Valvular heart disease (VHD) is the pathological defect affecting one of the four valves of the heart: aortic valve, mitral valve, pulmonic valve, or triscuspid valve. VHD may be congenital or acquired. Congenital causes of VHD include tetralogy of fallot, ebstein's anomaly, noonan syndrome, congenital rubella syndrome, and bicuspid valves, among others. Acquired causes of VHD include rheumatic heart disease, infective endocarditis, senile calcification of valves,
Classification
Valvular heart diseases are typically classified according to the valve that is affected as well as the nature of the pathological defect as follows:
Differential Diagnosis
Clinicians may differentiate among different valvular heart diseases on the basis of the characteristics of the murmur and collecting a thorough patient history, as shown in the following table:
Valvular Disease | Common causes | Murmur Description | |||
---|---|---|---|---|---|
Low/High
Frequency |
Systolic/Diastolic
Murmur |
Best Heard Location | Other Features | ||
Aortic stenosis |
|
Systolic | Right second intercostal space | ||
Aortic regurgitation |
|
||||
Mitral stenosis | |||||
Mitral regurgitation | |||||
Mitral valve prolapse | Mid-systolic click | ||||
Tricuspid stenosis | Low | Diastolic | Lower Left Sternal Border | ||
Tricuspid regurgitation | Low | Pansystolic | Mid Sternal Border | ||
Pulmonary stenosis | |||||
Pulmonary regurgitation |