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Valvular heart disease 

Valvular heart disease
Chapter:
Valvular heart disease
Author(s):

Francesca Mantovani

DOI:
10.1093/med/9780198759935.003.0016

July 29, 2020: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 27 February 2021

Valvular heart disease is common, and any of the four valves of the heart can be affected, although left-sided valvular disease is far commoner than right-sided disease. Treatment depends on the valvular disease type and severity but, when severe and symptomatic, usually involves mechanical intervention. Asymptomatic patients without objective parameters suggesting high morbid or lethal risk are closely observed clinically, until surgical indications develop. Although often prescribed, no rigorous evidence supports pharmacological therapy in most chronic valve diseases, although drugs may be useful in acute valvular diseases or as a bridge to surgery in severely decompensated patients. Moreover, given the rising proportion of frail older people with symptomatic degenerative valve disease, in whom the risks of mechanical intervention are prohibitive, medical treatment could be the only option.

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