1. HeartPoint: Valvular Heart Disease valvular heart disease HeartPoint animation this will take approximately 1 minute to load. It is easily understood that the muscle http://www.heartpoint.com/valvularheartdx.html

Valvular Heart Disease HeartPoint animation: this will take approximately 1 minute to load. It is easily understood that the muscle that we call the heart must continue to pump with adequate force to pump the blood that the body needs. "Valves" however are extremely important to the heart's efficiency. These delicate structures allow for the efficient flow of blood progressively forward through the heart's chambers, maximizing the efficiency of the heart muscle's work. To review the flow of blood through the heart, you can check out "The Heart" animation. link In the animation above, the Tricuspid Valve (between the right atrium and right ventricle) and the Pulmonic Valve (between the right ventricle and the pulmonary artery) are illustrated to be working normally. After the right ventricle contracts, pressure is low in the chamber. The Tricuspid Valve, which had been closed from the pressure generated from the ventricle's contraction, now opens as the pressure of the blood from the right atrium has built up while the Tricuspid Valve was closed. The right ventricle will again contract, closing the Tricuspid Valve again, and pushing open the Pulmonic Valve. Once the right ventricle completes its contraction, the pressure in the pulmonary artery will be higher than in the right ventricle, and the Valve will close. The valves on the left side of the heart, the Aortic Valve and the Mitral Valve however, are not working properly. Blood returns from the lungs and empties into the left atrium. In this illustration, the Mitral Valve opens properly when the left ventricle is finished contracting, and allows blood to flow into the left ventricle easily. When the left ventricle contracts however, blood is shown to flow back into the left atrium through the Mitral Valve. This backward flow of blood is called

2. Circulation -- Bonow Et Al. 98 (18): 1949 A report of the American College of Cardiology and American Heart Association Task Force on Practice Guidelines. http://circ.ahajournals.org/cgi/content/full/98/18/1949

PDF Version of this Article Citation Map Email this article to a friend Similar articles found in: Circulation Online PubMed PubMed Citation This Article has been cited by: other online articles Search PubMed for articles by: Bonow, R. O. Smith, S. C., Jr Alert me when: new articles cite this article Download to Citation Manager Circulation. ACC/AHA Practice Guidelines Guidelines for the Management of Patients With Valvular Heart Disease Executive SummaryA Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease) Committee Members Robert O. Bonow, MD, FACC, Chair Blase Carabello, MD, FACC Antonio C. de Leon, Jr, MD, FACC L. Henry Edmunds, Jr, MD, FACC Bradley J. Fedderly, MD, FAAFP Michael D. Freed, MD, FACC William H. Gaasch, MD, FACC Charles R. McKay, MD, FACC Rick A. Nishimura, MD, FACC Patrick T. O'Gara, MD, FACC Robert A. O'Rourke, MD, FACC Shahbudin H. Rahimtoola, MD, FACC Task Force Members James L. Ritchie, MD, FACC, Chair

3. HeartPoint: Valvular Heart Disease: Tell Me More valvular heart disease. How can you tell if I have an abnormal valve? Most cases of valvular heart disease can be detected with a stethoscope. http://www.heartpoint.com/valvularheartdxmore.html

Valvular Heart Disease What happens with valves that leak (regurgitation)? What happens with valves that don't open well (stenosis)? How can you tell if I have an abnormal valve? What is a heart "murmur"? ... What is "Endocarditis"? What happens with valves that leak (regurgitation)? Valves that leak cause the heart to have to pump the same blood twice . . . that is, a part of the work of the heart simply is for no good purpose, as the blood comes right back into the chamber. The heart has a number of ways it can compensate for this extra work. The first tendency is for the chambers to enlarge, since there is more blood to pump (the blood it usually would need to pump to the rest of the body plus the regurgitated blood). This is usually quite effective if the leakage is mild or moderate, and the person may not even realize there is any problem at all. In more severe cases, the heart muscle may begin to wear down. Congestive heart failure may then result, characterized by shortness of breath, swelling of the ankles, and other symptoms. The enlarged chambers may also lead to problems with arrhythmias. What happens with valves that don't open well (stenosis)?

4. Valvular Heart Disease A list of sites providing information on valvular heart disease A community of patients who have valvular heart disease. An excellent place to discuss valve problems and valve http://heartdisease.about.com/cs/valvulardisease

zJs=10 zJs=11 zJs=12 zJs=13 zc(5,'jsc',zJs,9999999,'') About Heart Disease / Cardiology Home Essentials ... BEWARE: Medical Offers are Ads zau(256,152,180,'gob','http://z.about.com/5/ad/go.htm?gs='+gs,''); Dealing With Heart Disease Reducing Cardiac Risk Cholesterol, triglycerides Heart Healthy Diet ... Help zau(256,138,125,'el','http://z.about.com/0/ip/417/0.htm','');w(xb+xb); Stay Current Subscribe to the About Heart Disease / Cardiology newsletter. zau(256,152,100,'hs','http://z.about.com/5/ad/hs.htm?zIhsid=00',''); Search Heart Disease / Cardiology Vavlular heart disease Guide picks A list of sites providing information on valvular heart disease The McGill University virtual stethoscope A very well-done site, that combines a virtual on-line stethoscope with impressive visuals. A review of valvular heart lesions A brief but well-written overview of the major valvular diseases Heart valve disease Everything you might want to know, from the Yale Medical School Heart Book, a book aimed at a general audience. Very comprehensive. An excellent resource. Requires Adobe Acrobat Valvular heart disease A concise review by Intellihealth.com

5. Valvular_Heart_Disease_Overview - HeartCenterOnline For Patients: Heart Health E American Heart Association member edited valvular heart disease Overview is just one of several cardiologistedited articles on valvular heart disease that you http://www.heartcenteronline.com/myheartdr/common/articles.cfm?ARTID=187

6. Valvular Heart Disease An extensive look at what valvular heart disease is, as well as the diagnosing and treatment. http://www.kfshrc.edu.sa/cardiovascular/html/valvular_heart_disease.html

KFSHRC Home Cardiovascular Diseases Department What is Valvular Heart Disease? How to Diagnose Valvular Heart Disease? ... How to Treat Valvular Heart Disease? What is Valvular Heart Disease? There are four chambers of the heart, two on the right side and two on the left. The upper chamber on the right side (right atrium) receives blood returned from various parts of the body and then empties to the right lower chamber (right ventricle). There is a valve between the right atrium and the ventricle, called tricuspid valve . This valve allows emptying of blood from the right atrium into the right ventricle and then closes to prevent the return of blood back into the right atrium. The other heart valves to be described later have similar functions i.e. regulating forward blood flow and preventing backward return. The right ventricle pumps the blood into the lungs where it gets oxygen. The blood here goes through another valve called the pulmonary valve .The blood is received by the left upper chamber (atrium) after it has received oxygen in the lungs. Then the left atrium empties the blood into the left lower chamber (ventricle) via a valve called the mitral valve . Finally, the blood is pumped from the left lower chamber (ventricle) to various parts of the body for supplying oxygen. The blood leaves the left ventricle via another valve called the

7. Postgraduate Medicine: Valvular Heart Disease valvular heart disease. Identifying and managing mitral and aortic lesions. Kevin M. Harris, MD; Paul Robiolio, MD. VOL 106 / NO 7 / DECEMBER 1999 / POSTGRADUATE MEDICINE. CME learning objectives http://www.postgradmed.com/issues/1999/12_99/harris.htm

Valvular heart disease Identifying and managing mitral and aortic lesions Kevin M. Harris, MD; Paul Robiolio, MD VOL 106 / NO 7 / DECEMBER 1999 / POSTGRADUATE MEDICINE CME learning objectives To identify and assess mitral regurgitation, aortic insufficiency, mitral stenosis, and aortic stenosis To recognize which lesions are amenable to medical treatment and which require surgery To appreciate the role of echocardiography and catheterization in delineating and treating valvular heart disease This page is best viewed with a browser that supports tables Preview : Recognition and management of valvular heart disease have evolved considerably in the past two decades, thanks in large part to advances in echocardiography. In this article, Drs Harris and Robiolio summarize the initial patient assessment, diagnostic procedures, and treatment options for mitral regurgitation, aortic insufficiency, mitral stenosis, and aortic stenosis. Harris KM, Robiolio P. Valvular heart disease: identifying and managing mitral and aortic lesions. Postgrad Med 1999;106(7):113-28 A dvances in the noninvasive evaluation of valvular lesions have significantly improved the clinician's ability to diagnose and follow the progression of valvular heart disease. Often, cardiac catheterization is necessary only in patients referred for surgery or mitral valvuloplasty. Once a valve lesion is identified, endocarditis prophylaxis is necessary and is often the only medical treatment indicated. Some patients with aortic insufficiency have been shown to benefit from medical treatment. However, no definitive medical treatment has been shown to change the natural history of other valvular lesions.

8. Guidelines For The Management Of Patients With Valvular Heart Disease: Executive From the American Heart Association, covers all the valve diseases, infective endocarditis, pregnancy, adolescents and young adults, prosthetic heart valves and coronary artery disease. http://www.americanheart.org/presenter.jhtml?identifier=1692

9. Valvular Heart Disease Case 4: Mitral Stenosis Study of a 46 year old woman who presents to the emergency room with palpitations and severe dyspnea. http://edcenter.med.cornell.edu/Pathophysiology_Cases/96-97_Pathophysiology_Case

Valvular Heart Disease Case 4 A 46 year old woman presents to the emergency room with palpitations and severe dyspnea. The woman recalls at least one, possibly more episodes of acute rheumatic fever during her childhood. She tolerated two pregnancies without difficulty. She was normally active and asymptomatic until age 42 when she noted dyspnea on moderate exertion. Evaluation at that time revealed a diastolic rumble at the LV apex, an EKG with normal sinus rhythm , and signs of left atrial hypertrophy. An echocardiogram revealed normal left ventricular internal dimensions but moderate left atrial enlargement. The mitral valve leaflets were thickened and motion of the valve leaflets was reduced. The mitral valve orifice was reduced to 1.5 cm (normal > 3 cm She was treated with diuretics and digoxin with improvement in her exertional dyspnea. Over the next 4 years her symptoms of exertional dyspnea increased gradually and she noted that she slept more comfortably if she elevated her head on several pillows. She also noted increased leg swelling over the past several months. On the night of admission, she awoke from sleep with palpitations and difficulty breathing. PHYSICAL EXAM: HR 120-130 irregular , BP 110/70

10. Valvular Heart Disease: Review And Update - June 1, 2001 - American Family Physi valvular heart disease Review and Update. BENJAMIN SHIPTON, D.O., Mercer, Pennsylvania. HANEY WAHBA, M.D., Mercy Hospital of Pittsburgh, Pittsburgh, Pennsylvania People with valvular heart disease are living longer, with less morbidity, than ever of patients with valvular heart disease. Generally, patients with stenotic valvular lesions can http://www.aafp.org/afp/20010601/2201.html

Advanced Search Valvular Heart Disease: Review and Update BENJAMIN SHIPTON, D.O., Mercer, Pennsylvania HANEY WAHBA, M.D., Mercy Hospital of Pittsburgh, Pittsburgh, Pennsylvania A PDF version of this document is available. Download PDF now (8 pages / 126 KB). More information on using PDF files. F amily physicians routinely encounter patients with valvular heart disease. Although major advances in our understanding of this disease have been made in the past two decades, only recently has there been evidence-based literature from which to draw conclusions about its diagnosis and management. The American College of Cardiology and American Heart Association (ACC/AHA) Task Force recently published comprehensive practice guidelines to help clinicians manage this challenging disorder. Improved surgical techniques, noninvasive techniques for surveillance of left ventricular function and guidelines for the timing of surgery have likely combined to contribute to improved survival and decreased morbidity in patients with chronic valvular heart disease. FIGURE 1.

11. Valvular Heart Disease Scientific Statement Topic List valvular heart disease Guidelines Guidelines for the Management of Patients With valvular heart disease, Full Text Guidelines for the Management of Patients With valvular heart disease, Executive Summary http://www.americanheart.org/presenter.jhtml?identifier=3004595

12. Stanford Interventional Cardiology Stanford Interventional Cardiology is a world leader in percutaneous coronary revascularization. We perform over 1000 interventions per year and offer the latest breakthroughs in the treatment of coronary artery disease and valvular heart disease. http://cvmed.stanford.edu/interventional/home.htm

Home About Us Fellowships Services ... Toolbox Go here for the main Division page. Welcome Stanford Interventional Cardiology is a world leader in percutaneous coronary revascularization. We perform over 1000 interventions per year and offer the latest breakthroughs in the treatment of coronary artery disease and valvular heart disease. Our site will be updated regularly and parts of it are currently under construction. We apologize for any inconvenience this may cause. Feel free to give us feedback on our site and let us know what topics you would like to see. What's New DRUG-ELUTING STENT CONFERENCE at Stanford Saturday, January 18 8 AM - NOON THANKS to everyone for supporting the program. Click here to get the slides which are in Adobe Acrobat format. If you don't have a reader, click here . Go to "Downloads" and "Free Reader". We are offering new services including ASD and PFO closures and alcohol septal ablation for hypertrophic cardiomyopathy. Call us for details! Clinical Trials Update!

13. Heart Valve Disease (Valvular Heart Disease) right side. The two main types are regurgitation (leaking) and stenosis (narrowing). Heart Valve Disease (valvular heart disease). http://www.heartcenteronline.com/Valvular_Heart_Disease_Overview.html

Heart Valve Disease (Valvular Heart Disease) Heart valve disease (valvular heart disease) is the name given to any dysfunction or abnormality of one or more of the heart's four valves, including the mitral and aortic valves on the left side, and the tricuspid and pulmonic valves on the right side. The two main types of valvular disease, regurgitation (leaking) and stenosis (narrowing) of the valves. In a normally functioning heart, the four valves (flaps made of tissue) keep blood flowing in one direction and only at the right time. They act as gates that swing open to allow blood to flow through and then tightly shut until the next cycle begins. There are a number of different types of valvular diseases. Valvular stenosis is a condition in which there is a narrowing, stiffening, thickening, fusion or blockage of one or more cardiac valves. Depending on which area is affected, the patient will be diagnosed with aortic stenosis, mitral stenosis, pulmonic stenosis or tricuspid stenosis. Valvular regurgitation is a condition in which blood leaks back in the wrong direction because one or more of the cardiac valves is closing improperly. Depending on the area affected, the patient will be diagnosed with aortic regurgitation, mitral regurgitation, pulmonary regurgitation or tricuspid regurgitation. Valvular atresia is a serious condition in which one of the valves has failed to develop properly and is completely closed at birth. Depending on which area is affected, the patient will be diagnosed with aortic atresia, mitral atresia

14. Valvular Heart Disease valvular heart disease. 5/22/00. Click here to start. valvular heart disease. valvular heart disease. valvular heart disease. Rheumatic Fever. Rheumatic Fever. Rheumatic Fever. Rheumatic Fever. Rheumatic Fever Morphology. Acute Rheumatic Carditis http://pathophysiology.uams.edu/fall/lectures/lect28f00

Valvular Heart Disease Click here to start Table of Contents Valvular Heart Disease Valvular Heart Disease Valvular Heart Disease Rheumatic Fever ... FINIS Author: Robin Jones Email: roulstoncheryld@exchange.uams.edu Home Page: http://pathophysiology.uams.edu

15. Medical Library: Valvular Heart Disease valvular heart disease. Overview. Clinical Presentation. SYMPTOMS Common symptoms of valvular heart disease may include the following Weakness on exertion; http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZLNKW728C&sub_cat=2

16. Valvular Heart Disease A Brief Survey of valvular heart disease. I am your Guide, From Richard N. Fogoros, Your Guide to Heart Disease / Cardiology. While http://heartdisease.about.com/library/bl101valves.htm

zJs=10 zJs=11 zJs=12 zJs=13 zc(5,'jsc',zJs,9999999,'') About Heart Disease / Cardiology Home Essentials ... BEWARE: Medical Offers are Ads zau(256,152,180,'gob','http://z.about.com/5/ad/go.htm?gs='+gs,''); Dealing With Heart Disease Reducing Cardiac Risk Cholesterol, triglycerides Heart Healthy Diet ... Help zau(256,138,125,'el','http://z.about.com/0/ip/417/0.htm','');w(xb+xb); Stay Current Subscribe to the About Heart Disease / Cardiology newsletter. zau(256,152,100,'hs','http://z.about.com/5/ad/hs.htm?zIhsid=00',''); Search Heart Disease / Cardiology Email to a friend Print this page Stay Current Subscribe to the About Heart Disease / Cardiology newsletter. Suggested Reading Survey of cardiomyopathy Survey of coronary artery disease Survey of heart arrhythmias Most Popular How to increase your HDL levels The South Beach Diet Contoversy Symptom checker Cholesterol and triglycerides ... Is Chocolate Really Good For You? What's Hot Is Chocolate Really Good For You? Exercise for heart failure aneurysm cardiac electrical system - AV conduction ... Cardiac arrhythmias - ventricular fibrillation A Brief Survey of Valvular Heart Disease From Richard N. Fogoros

17. CNN - Valvular Heart Disease Associated With Fenfluramine-phentermine - June 8, valvular heart disease associated with fenfluraminephentermine. valvular heart disease in patients taking anoretic agents has not been reported. http://www.cnn.com/HEALTH/9707/08/fenphen.report/

Valvular heart disease associated with fenfluramine-phentermine July 8, 1997 Web posted at: 2:58 p.m. EDT (1858 GMT) Heidi M. Connolly, M.D. Jack L. Crary, M.D. Michael D. McGoon, M.D. Donald D. Hensrud, M.D., M.P.H. Brooks S. Edwards, M.D. William D. Edwards, M.D. Hartzell V. Schaff, M.D. From the Divisions of Cardiovascular Diseases and Internal Medicine (H.M.C., M.D.M., B.S.E.), Preventive and Occupational Medicine, Endocrinology and Internal Medicine (D.D.H.), Anatomic Pathology (W.D.E.), Thoracic and Cardiovascular Surgery (H.V.S.), Mayo Clinic and Mayo Foundation, Rochester, Minnesota, and the MeritCare Medical Center, Heart Services, Fargo, North Dakota (J.L.C.). Address reprint requests to Dr. Connolly at Mayo Clinic, 200 First Street SW, Rochester, MN 55905 NOTE: This is the manuscript of the study that has been submitted to The New England Journal of Medicine. The published version of the report may differ. ABSTRACT Background Fenfluramine and phentermine are anorectic agents individually approved by the United States Food and Drug Administration. The drugs used in combination may yield equivalent efficacy in weight reductions at lower doses of each agent and with fewer reported side effects. In 1996, the total number of prescriptions in the United States for fenfluramine and phentermine exceeded 18 million. Methods Valvular heart disease was identified in 24 women treated with fenfluramine-phentermine who had no previous history of cardiac disease. Patients presented with symptoms or a murmur. A perceived association between the clinical features and the fenfluramine-phentermine therapy evolved by communication among authors.

18. Management Of Patients With Valvular Heart Disease Guidelines REPORT JACC Vol. 32, No. 5, November 199814861588. ACC/AHA Guidelines for the Management of Patients With valvular heart disease. http://www.acc.org/clinical/guidelines/valvular/dirindex.htm

var showMenu="ExpandMain:clinical;"; // document.modified = "Tuesday March 12, 2002"; document.modified = "03/12/2002"; Table of Contents Print a PDF References BONOW ET AL., ACC/AHA TASK FORCE REPORT JACC Vol. 32, No. 5, November 1998:1486-1588 ACC/AHA 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 (Committee on Management of Patients With Valvular Heart Disease) COMMITTEE MEMBERS Robert O. Bonow, MD, FACC, Chair , Blase Carabello, MD, FACC, Antonio C. De Leon, Jr., MD, FACC, L. Henry Edmunds, Jr., MD, FACC, Bradley J. Fedderly, MD, FAAFP, Michael D. Freed, MD, FACC, William H. Gaasch, MD, FACC, Charles R. Mckay, MD, FACC, Rick A. Nishimura, MD, FACC, Patrick T. O'Gara, MD, FACC, Robert A. O'Rourke, MD, FACC, Shahbudin H. Rahimtoola, MD, FACC TASK FORCE MEMBERS James L. Ritchie, MD, FACC

19. Medical Library Valvular Heart Disease valvular heart disease is commonly caused by damage to the heart muscle as a result of rheumatic Patients with valvular heart disease are also at risk for bacterial endocarditis http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZLNKW728C&sub_c

20. Management Of Patients With Valvular Heart Disease Guidelines:Management Of Valv 32, No. 5, November 199814861588. ACC/AHA Guidelines for the Management of Patients With valvular heart disease. V. Management of Valvular Disease in Pregnancy. http://www.acc.org/clinical/guidelines/valvular/jac5929fla119.htm

var showMenu="ExpandMain:clinical;"; // document.modified = "Tuesday March 12, 2002"; document.modified = "03/12/2002"; Table of Contents Print a PDF References BONOW ET AL., ACC/AHA TASK FORCE REPORT JACC Vol. 32, No. 5, November 1998:1486-1588 ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease V. Management of Valvular Disease in Pregnancy A. Physiological Changes of Pregnancy There is a further abrupt increase in cardiac output during labor and delivery related in part to the associated anxiety and pain. Uterine contractions can lead to marked increases in both systolic and diastolic blood pressure. After delivery, there is an initial surge in preload related to the autotransfusion of uterine blood into the systemic circulation and to caval decompression ( Pregnancy is also associated with a hypercoagulable state owing to relative decreases in protein S activity, stasis, and venous hypertension (

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