Aortic insufficiency stages: Difference between revisions
(→Stages) |
(→Stages) |
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| B | | B | ||
| Progressive [[AR]] | | Progressive [[AR]] | ||
| ❑ Mild-to-moderate calcification <br> ❑ Rheumatic valve changes | | ❑ Mild-to-moderate calcification <br> ❑ Rheumatic valve changes <br> ❑ Dilatation of aortic sinuses <br> ❑ [[Infective endocarditis]] | ||
<br> ❑ Dilatation of aortic sinuses <br> ❑ [[Infective endocarditis]] | |||
| ❑ Mild [[AR]]: | | ❑ Mild [[AR]]: | ||
: ❑ Jet/LVOT <25% | : ❑ Jet/LVOT <25% | ||
Line 71: | Line 70: | ||
| D | | D | ||
| Symptomatic severe [[AR]] | | Symptomatic severe [[AR]] | ||
| ❑ Calcific aortic valve disease <br> ❑ Rheumatic valve changes | | ❑ Calcific aortic valve disease <br> ❑ Rheumatic valve changes <br> ❑ Dilated aortic sinuses <br> ❑ [[Infective endocarditis]] with abnormal leaflet closure | ||
<br> ❑ Dilated aortic sinuses <br> ❑ [[Infective endocarditis]] with abnormal leaflet closure | |||
| | ❑ Severe [[AR]] | | | ❑ Severe [[AR]] | ||
: ❑ Jet/LVOT ≥65% | : ❑ Jet/LVOT ≥65% |
Revision as of 19:44, 9 April 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
According to the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease, aortic insufficiency has 4 stages based on the valve's anatomy, hemodynamics and the patients symptoms.
Stages
Shown below is a table summarizing the stages of aortic regurgitation (AR) according to the 2014 AHA/ACC guidelines for the management of patients with valvular heart disease. [1]
Abbreviations: AR: aortic regurgitation; HF: heart failure; IE: infective endocarditis; LV: left ventricular; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic dimension; LVOT: left ventricular outflow tract; Jet/LVOT : jet width and LVOT ratio
STAGE | DEFINITION | VALVE ANATOMY | VALVE HEMODYNAMICS | HEMODYNAMIC CONSEQUENCES | SYMPTOMS |
---|---|---|---|---|---|
A | At risk of AR | ❑ Bicuspid valve ❑ Valve sclerosis ❑ History of rheumatic fever ❑ Infective endocarditis |
❑ None | ❑ None | ❑ None |
B | Progressive AR | ❑ Mild-to-moderate calcification ❑ Rheumatic valve changes ❑ Dilatation of aortic sinuses ❑ Infective endocarditis |
❑ Mild AR:
|
❑ Normal LV systolic function ❑ Normal LV volume or mild LV dilation |
❑ None |
C | Asymptomatic severe AR | ❑ Calcific aortic valve disease ❑ Rheumatic valve changes ❑ Bicuspid valve ❑ Dilated aortic sinuses ❑ Infective endocarditis with abnormal leaflet closure |
❑ Severe AR
|
❑ C1: Normal LVEF and mild to moderate LV dilatation ❑ C2: abnormal LV systolic function with decreased LVEF or severe LV dilatation |
❑ None ❑ Exercise testing to confirm symptom status |
D | Symptomatic severe AR | ❑ Calcific aortic valve disease ❑ Rheumatic valve changes ❑ Dilated aortic sinuses ❑ Infective endocarditis with abnormal leaflet closure |
❑ Severe AR
|
❑ May occur with normal systolic function or decreased function ❑ Presence of moderate to severe LV dilatation |
❑ Exertional dyspnea ❑ Exertional angina ❑ HF symptoms
|
References
- ↑ "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary". Retrieved 4 March 2014.