What Is Valvular Heart Disease?

Author: [US] Albert, eds, GUO Ji master translation ^[1]

Valvular heart disease

Author: [US] Albert, eds, GUO Ji master translation ^[1]

Publisher: Science Press

Publication time: 2003-1-1

Edition: 1

Pages: 410

Word Count: 608000

Printing time: 2003-1-1

format:

Paper: offset paper

Impressions:

ISBN: 9787030106230

Packaging: Hardcover

Introduction to valvular heart disease

This book is the latest expert on heart disease written by a well-known American expert. It is comprehensive, informative, and illustrated. It fully reflects the recent theoretical and practical progress of valvular heart valves, especially the focus on clinical diagnosis and treatment. Evidence-based medicine is used to guide clinical practice, and an incisive summary from the latest international research level is particularly suitable for reference by cardiology clinicians and related researchers.

Valvular heart disease catalog

Chapter 1 Pathogenesis and Pathology of Heart Valve Disease

Chapter Two Rheumatic Fever

Chapter 3 Mitral Valve Stenosis

Chapter 4 Chronic Mitral Valve Reflux

Chapter 5 Acute Mitral Valve Reflux

Chapter 6 Mitral Valve Prolapse Syndrome

Chapter 7 Aortic Stenosis

Chapter VIII Chronic Aortic Valve Reflux

Chapter IX Acute Aortic Valve Insufficiency

Chapter 10 Combined Valvular Disease

Chapter XI Pulmonary Valve Disease

Chapter 12 Tricuspid Valve Disease

Chapter 13 Prosthetic Heart Valve

Chapter 14 Antimicrobial Prevention of Bacterial Endocarditis and Acute Rheumatic Fever

Chapter 15 Endocarditis: A Long-Term Problem

Chapter 16 Antithrombotic Therapy of Artificial Heart Valves

Chapter 17 Anticoagulation in Patients with Valve Heart Disease and Atrial Fibrillation

Classification of common valvular diseases of valvular heart disease

Mitral valve disease: mitral stenosis, mitral regurgitation, including mitral valve vegetation, mitral valve prolapse, and mitral annulus calcification

Aortic valve disease: aortic valve stenosis, aortic valve insufficiency, aortic valve prolapse, aortic valve perforation, aortic valve tear, aortic valve vegetation

Pulmonary artery disease: pulmonary valve regurgitation, pulmonary valve vegetation, pulmonary hypertension

Tricuspid valve disease: Tricuspid stenosis, tricuspid regurgitation, tricuspid valve vegetation

Auxiliary tests for valvular heart disease

Common clinical examinations of heart valve disease include auscultation, electrocardiogram, X-rays, echocardiography (cardiac ultrasound) and so on.

Auscultation: The normal heart has two heart sounds, which are the sound of the valve closing. The first heart sound is the sound of the mitral and tricuspid valves closing at the same time, and the first heart sound is the sound of the aortic and pulmonary valves closing at the same time. When the doctor auscultates, he can hear an abnormal heart sound called a murmur. The valve is inherently stiff, narrow, or incompletely closed, and can produce murmurs as blood passes.

Electrocardiogram: Examination results of valvular heart disease and the specific type of valvular disease vary.

Experts from Hangzhou 117 Hospital said that about one third of patients with mitral valve prolapse syndrome have abnormal electrocardiograms, mainly ST segment and T wave changes. QT interval is prolonged, U wave is obvious, arrhythmia and conduction disorder.

(1) T wave: About one-third of patients have low, flat, biphasic, or inverted T waves in leads II, III, and aVF. Some patients can extend to the left or right chest lead. Patients with chest pain are easily misdiagnosed as coronary heart disease. Propranolol test can improve the ST? T segment and T wave changes in 80% of patients. This helps distinguish it from ischemic ST segment and T wave changes.

(2) ST segment: there may be significant ST segment depression after exercise.

(3) Prolongation of QT interval is uncommon, but it is one of the features and may be related to sudden death.

(4) The u-wave amplitude increases, reaching about 50% of the T-wave.

(5) Ventricular premature pulsation is the most common, followed by ventricular tachycardia, supraventricular tachycardia, atrial premature pulsation and atrial fibrillation. A few may have ventricular fibrillation or bradycardia.

(6) Occasional conduction disorder: I degree AV block is more, II degree and III degree AV block are rare, and bundle branch block is more rare. Occasionally preexcitation syndrome.

X-rays: Early enlargement of the left atrium, esophageal radiography can be seen in the lateral view of the esophagus caused by the enlarged left atrium. In the posterior anterior radiograph, double atrial shadows with overlapping left and right atria can be seen on the right edge of the heart shadow. The aorta is small and the pulmonary artery segment is eminent.

Color Doppler Ultrasound: It is a commonly used and very accurate method for the diagnosis of valvular heart disease. You can directly see the mitral valve thickening, calcification, restricted opening, incomplete closure, contracture and shortening of the tendon, and the aortic valve. You can see that there are restrictions on opening, or cracks on closing. Cardiac ultrasound is also the only instrument that can visually display valve lesions. Through the measurement of color ultrasound, doctors can understand the degree of valve lesions to decide conservative or surgical treatment.

Evaluation criteria of heart valve ultrasound for valvular heart disease

Aortic valve calcification: thickening of the aortic valve (thickness> 3 mm); enhanced echo, stiff leaflets, and restricted movement; limited rapid spot reflex enhancement at the aortic annulus enhancement aortic root echo reflection;

Mitral valve calcification: enhanced submitral valve echo, mitral annulus calcification (endocardial echo);

Closed incompleteness: Adopting the reverse beam area method, 40% are severely closed incompletely.

Stenosis: The mean blood pressure difference between 1 and 33 kPa is 3 to 33 kPa for mild stenosis, 3 to 33 to 6 k67 for moderate stenosis, and 6 to 67 kPa for severe stenosis. ^[2]