![]() TTE: to assess cardiac structure, valve morphology, and hemodynamics.ECG: to assess cardiac rhythm and check for signs of ventricular hypertrophy.The approach to management depends on the type and severity of VHD, the patient's individual risk profile (e.g., comorbidities, age, and fitness level), evaluation of risks and benefits of each procedure, and shared decision-making. Refer patients without indications for valve intervention at diagnosis to a cardiologist for monitoring.Īcutely decompensated VHD (e.g., presenting as cardiogenic shock, acute heart failure, or acute arrhythmia symptoms) requires urgent management and cardiology consultation.Refer patients with indications for interventional treatment (e.g., those with severe and/or symptomatic VHD):.Classify the disease according to severity.Consider the need for advanced studies to identify symptom etiology and further characterize valvular lesions.Perform a thorough initial evaluation, including TTE and assessment of symptoms and comorbidities.See the respective articles on aortic stenosis, aortic regurgitation, mitral stenosis, and mitral regurgitation for the management of acutely decompensated VHD, and for further details on the management of chronic VHD. This section provides a general overview of various management strategies for valvular heart diseases (VHDs). Augmentation of the murmur 's intensity with inspiration ( Carvallo sign ).Tricuspid valve ( parasternal 4 th left ICS ).Tricuspid valve (parasternal 4 th left ICS ).Graham Steell murmur: high-frequency decrescendo diastolic murmur.Possible early systolic pulmonary ejection click and/or widely split 2 nd heart sound Crescendo-decrescendo ejection systolic murmur.Pulmonary valve (parasternal 2 nd left ICS).Midsystolic high-frequency clic k (due to the tensing of the chordae tendinae). ![]()
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