Bicuspid aortic stenosis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]; Usama Talib, BSc, MD [3]

For medical therapy of aortic stenosis, click here.

Overview

There is no specific medical treatment for patients with bicuspid aortic valves. However, the patients should be followed-up regularly to evaluate the progress and early recognition of complications such as valve insufficiency, stenosis, progressive aortic root dilation, aneurysm, dissection and prevention of possible endocarditis. Since high lipid levels may accelerate the calcification of a congenital bicuspid aortic valve, a heart-healthy diet is recommended for all patients.[1][2][3]

Physical Activity

Patients with normally functioning bicuspid aortic valve have no restrictions for any kind of activities after ruling out other pathologic conditions of aorta.[4] However, patients who develop bicuspid aortic stenosis or insufficiency, should avoid strenuous competitive sports.[5]

2008 and Incorporated 2006 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT) [6]

Bicuspid Aortic Valve With Dilated Ascending Aorta (DO NOT EDIT) [6]

Class IIa
"1. It is reasonable to give beta-adrenergic blocking agents to patients with bicuspid valves and dilated aortic roots (diameter greater than 4.0 cm*) who are not candidates for surgical correction and who do not have moderate to severe AR. (Level of Evidence: C)"
* Consider lower threshold values for patients of small stature of either gender.

Sources

  • 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease [6]

References

  1. "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
  2. "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
  3. "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.
  4. Stefani L, Galanti G, Toncelli L, Manetti P, Vono MC, Rizzo M, Maffulli N (2008). "Bicuspid aortic valve in competitive athletes". British Journal of Sports Medicine. 42 (1): 31–5, discussion 35. doi:10.1136/bjsm.2006.033530. PMID 17548371. Retrieved 2012-04-11. Unknown parameter |month= ignored (help)
  5. De Mozzi P, Longo UG, Galanti G, Maffulli N (2008). "Bicuspid aortic valve: a literature review and its impact on sport activity". British Medical Bulletin. 85: 63–85. doi:10.1093/bmb/ldn002. PMID 18296454. Retrieved 2012-04-11.
  6. 6.0 6.1 6.2 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter |month= ignored (help)

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