Management of acute regurgitation in left-sided cardiac valves

Tex Heart Inst J. 2011;38(1):9-19.

Abstract

The management of acute, severe cardiac valvular regurgitation requires expeditious multidisciplinary care. Although acute, severe valvular regurgitation can be a true surgical emergency, accurate diagnosis and subsequent treatment decisions require clinical acumen, appropriate imaging, and sound judgment. An accurate and timely diagnosis is essential for successful outcomes and requires appropriate expertise and a sufficiently high degree of suspicion in a variety of settings. Whereas cardiovascular collapse is the most obvious and common presentation of acute cardiac valvular regurgitation, findings may be subtle, and the clinical presentation can often be nonspecific. Consequently, other acute conditions such as sepsis, pneumonia, or nonvalvular heart failure may be mistaken for acute valvular regurgitation. In comparison with that of the right-sided valves, regurgitation of the left-sided valves is more common and has greater clinical impact. Therefore, this review focuses on acute regurgitation of the aortic and mitral valves.

Keywords: Acute disease; aortic valve insufficiency/classification/complications/diagnosis/etiology/physiopathology/surgery/therapy; cardiology/standards; echocardiography; endocarditis, bacterial/physiopathology/therapy; heart valve diseases/diagnosis/etiology/physiopathology/surgery/therapy; heart valve prosthesis implantation/standards; mitral valve insufficiency/classification/complications/diagnosis/etiology/physiopathology/surgery/therapy; physical examination; prosthesis failure.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Aortic Valve Insufficiency / diagnosis
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / physiopathology
  • Aortic Valve Insufficiency / surgery*
  • Cardiac Surgical Procedures*
  • Hemodynamics
  • Humans
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / etiology
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Predictive Value of Tests
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome