Materiały źródłowe

• #1 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  To diagnose aortic valve disease, a health care professional examines you and asks questions about your symptoms and medical history. […] A whooshing sound, called a heart murmur, may be heard when listening to the heart with a stethoscope. If so, you may need to see a doctor trained in heart diseases, called a cardiologist. […] Tests to diagnose aortic valve disease include: […] Echocardiogram. An echocardiogram uses sound waves to create pictures of the beating heart. It shows how blood flows through the heart and heart valves. It can help determine the severity of aortic valve disease. […] Electrocardiogram (ECG or EKG). This quick test records the electrical activity of the heart. It shows how the heart beats. […] Chest X-ray. A chest X-ray shows the condition of the heart and lungs. It can help determine if the heart is enlarged, which can be a sign of certain types of aortic valve disease or heart failure.

• #1 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  Cardiac MRI. A cardiac MRI uses magnetic fields and radio waves to create detailed pictures of the heart. This test may be used to determine the severity of aortic valve disease and measure the size of the aorta. […] Cardiac computerized tomography (CT) scan. A cardiac CT scan uses a series of X-rays to create detailed images of the heart and heart valves. The test may be done to measure the size of the aorta and look at the aortic valve more closely. A CT scan also may be used to measure the amount of calcium in the aortic valve or determine the severity of aortic valve stenosis. […] Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while an ECG or echocardiogram is done. Exercise tests show how the heart reacts to physical activity and whether valve disease symptoms occur during exercise.

• #1 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  Cardiac catheterization. This test isn’t often used to diagnose aortic valve disease. But it may be done to see how severe aortic valve disease is or to diagnose the condition if other tests can’t. […] After testing confirms a diagnosis of aortic or other heart valve disease, your health care team may tell you the stage of disease. Staging helps determine the most appropriate treatment. […] The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: […] Stage A: At risk. Risk factors for heart valve disease are present. […] Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms.

• #1 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  Stage C: Asymptomatic severe. There are no heart valve symptoms but the valve disease is severe. […] Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms. […] Treatment for aortic valve disease depends on: […] The severity (stage) of aortic valve disease. […] Whether the disease is causing symptoms. […] Whether the condition is getting worse. […] Treatment may include regular health checkups, lifestyle changes, medicines, or surgery or other procedures. […] If you have aortic valve disease, consider being evaluated and treated at a medical center with a multidisciplinary team of heart doctors called cardiologists and other care professionals trained and experienced in evaluating and treating heart valve disease.

• #2 About Heart Valve Disease | Heart Disease | CDC

  https://www.cdc.gov/heart-disease/about/heart-valve-disease.html

  Heart valve disease is when any valve in the heart has damage or is diseased. […] Any valve in the heart can become diseased, but the aortic valve is most commonly affected. […] If the heart valves are diseased, the heart can’t effectively pump blood throughout the body and has to work harder to pump, either while the blood is leaking back into the chamber or against a narrowed opening. […] Early diagnosis, treatment, and routine monitoring of heart valve disease are critical to helping patients live healthy lives. […] Screenings such as stethoscope checks, echocardiograms, and timely referrals to cardiologists can help ensure that heart valve disease does not go unmanaged. […] Effective treatment options are available for heart valve disease, including noninvasive options. […] As with any heart condition, continued care and regular screenings to monitor disease progression are needed for people who are living with heart valve disease.

• #3 Aortic Valve Disease > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/aortic-valve-disease

  How is aortic valve disease diagnosed? To diagnose aortic valve disease, your doctor will review your medical history, perform a physical exam, and run diagnostic tests. […] They will begin to make a diagnosis by asking about your symptoms. During the physical exam, your doctor will check your blood pressure and pulse, and use a stethoscope to listen for a characteristic heart murmur or clicking sound. […] To confirm a diagnosis, your doctor will need to run one or more diagnostic tests. The main test for aortic valve disease is an echocardiogram. This test uses sound waves to produce images of the heart as it moves. Other imaging tests may be necessary, including a chest X-ray, a magnetic resonance imaging (MRI) study of the heart, or a computed tomography (CT) scan. […] Sometimes an electrocardiogram, also known as an ECG or EKG, is part of the workup. This test measures the hearts electrical activity, and while it is not used to diagnose aortic valve disease, it helps doctors evaluate how well the heart is working.

• #4 Physical examination in aortic valve disease: do we still need it in the modern era?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/physical-examination-in-aortic-valve-disease-do-we-still-need-it-in-the-modern

  Compared to echocardiography, auscultation is of low sensitivity in detecting aortic valve lesions (56.6-73%), but has a high agreement rate between examiners and a high specificity (92-98%). This is why, even in the era of high technology, physical examination still plays a crucial role in the screening, diagnosis and the severity assessment of aortic valve disease. […] For many years, the physical examination based mostly on cardiac auscultation represented the most useful bedside diagnostic tools for the diagnosis of these diseases. […] Until now, there has been no evidence to support the role of auscultatory devices in increasing the sensitivity of auscultation. […] The physical examination has also an important role in the preoperative assessment of patients before non-cardiac surgery.

• #5 Diagnosing Aortic Valve Disease | NYU Langone Health

  https://nyulangone.org/conditions/aortic-valve-disease/diagnosis

  At NYU Langone, our specialized heart valve physicians work as a team to diagnose and treat aortic valve stenosis and aortic valve regurgitation, the most common types of aortic valve disease. […] Your doctor may suspect aortic valve stenosis if during a routine physical exam he or she hears a heart murmur, which is an extra or unusual sound that occurs with a heartbeat. […] To help diagnose aortic valve disease, your doctor talks to you about your medical history and conducts a physical exam. Then he or she may request one or more of the following tests, which can typically be performed on the day of your initial doctors visit. […] An echocardiogram uses sound waves to create images of the hearts chambers and valves and the aorta. This helps your doctor determine how well the heart valves are working.

• #5 Physical examination in aortic valve disease: do we still need it in the modern era?

  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/physical-examination-in-aortic-valve-disease-do-we-still-need-it-in-the-modern

  Physical examination often provides the first clue to the presence of AS and helps in assessing the severity of the lesion. […] The most important auscultatory findings in AS are: a normal first sound (S1), a soft and single second sound (S2), the presence of an aortic ejection click and the typical basal systolic murmur. […] The presence of three or four associated findings – slow carotid artery upstroke, reduced carotid artery volume, maximal murmur intensity at the second right intercostal space, and reduced or absent second heart sound – effectively rules in AS. […] The following signs help in the diagnosis of severe AS, but no combination of physical findings has both a high sensitivity and specificity, particularly in asymptomatic patients. […] If we are aware of its limitations and strengths and we succeed in keeping our expertise and proficiency in cardiac auscultation, then clinical examination remains a valuable and cost-effective tool that often enables a rapid, integrative, accurate and patient-orientated diagnosis of aortic valve disease. Although advanced technologies have become part of our daily lives as clinicians, physical examination still plays a crucial role in the screening, diagnosis and evaluation of the severity of aortic valve disease, especially in AS.

• #6 Getting an Accurate Heart Valve Diagnosis | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/getting-an-accurate-heart-valve-diagnosis

  A heart murmur can be harmless, known as an innocent murmur, but many heart murmurs will need further investigation by your health care professional. […] There are several methods for diagnosing heart valve disease. The most important is the echocardiogram. […] To fully understand your heart valve problem, your medical team may want to perform a series of tests to provide a complete picture of what needs repair and what may be best left alone.

• #6 Getting an Accurate Heart Valve Diagnosis | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/getting-an-accurate-heart-valve-diagnosis

  You’ll need a careful evaluation to decide on the best treatment. […] Several tests can provide information about your heart valves and your circulation. Those tests are described in this section as they relate to valve disease. […] Your health care team will use diagnostic criteria to assess your needs and determine the severity of problems you might be having. The first diagnostic measure is usually auscultation, which is listening to your heart and any unusual sounds or murmurs with a stethoscope. […] Sometimes, the echocardiogram (echo) will provide all the needed information to decide on a treatment plan or to rule out the need for further treatment. […] Sometimes, the information from the echo alone doesn’t provide all the information. You may need further testing including an exercise test, chest X-rays, CT scan and sometimes cardiac catheterization.

• #7 What Is Aortic Valve Disease?

  https://my.clevelandclinic.org/health/diseases/24452-aortic-valve-disease

  Aortic valve disease is a form of heart valve disease that prevents your aortic valve from working properly. […] The two types of aortic valve disease are aortic regurgitation and aortic stenosis. […] Its important to know that you could have one or both types of aortic valve disease and not realize it for a long time. […] Learning about aortic valve disease can help you catch problems early and receive necessary treatment. […] Aortic valve disease gradually gets worse over time. Healthcare providers use these stages to describe the severity of your condition: […] Healthcare providers diagnose aortic valve disease through a physical exam and testing. […] An echocardiogram is the gold standard for diagnosing aortic valve disease. […] Treatment depends on: […] Your healthcare provider will evaluate your situation and recommend the best treatment plan for you.

• #8 Testing for Heart Valve Problems | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/getting-an-accurate-heart-valve-diagnosis/testing-for-heart-valve-problems

  An echocardiogram looks at your heart’s structure and checks how well your heart functions. The test provides information about: […] If the heart valves are working correctly. […] If blood is leaking backward through your heart valves (regurgitation). […] If the heart valves are too narrow (stenosis). […] A leaking or regurgitating valve can also affect the pressure in both the heart chambers as well as surrounding blood vessels. […] The valve gradient can be used to determine the severity of the valve disorder. […] The valve area is in square centimeters and can be used to determine the severity of the valve disorder. […] Exercise testing can provide valuable information in people with valvular heart disease, especially in those whose symptoms may be difficult to assess. […] A chest X-ray shows the location, size and shape of the heart, lungs and blood vessels. This can provide clues to a valve problem that include an enlarged or thickened heart and calcium deposits on the aorta or pericardium.

• #8 Testing for Heart Valve Problems | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/getting-an-accurate-heart-valve-diagnosis/testing-for-heart-valve-problems

  A CT scan creates images of the valve anatomy and allows for evaluation of the severity of stenosis and regurgitation. […] Cardiac catheterization can provide important information about narrowed heart valves, leaky heart valves or blood that is not flowing through the heart as it should. […] Cardiac magnetic resonance imaging (CMR) has become an optimal technique in assessing people with heart valve disease without the need for radiation. Its enhanced diagnostic power can: Determine the type and severity of valve disease. […] Measure heart function or how much blood the left ventricle can pump out to the body.

• #9 Heart valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heart-valve-disease/diagnosis-treatment/drc-20353732

  To diagnose heart valve disease, a health care professional examines you and asks questions about your symptoms and health history. A whooshing sound called a heart murmur may be heard when listening to your heart with a device called a stethoscope. […] Blood and imaging tests may be done to check your heart health. […] Tests to diagnose heart valve disease may include: […] Echocardiogram. This test uses sound waves to create pictures of the beating heart. It shows how blood flows through the heart and the health of the heart valves. […] Electrocardiogram (ECG or EKG). This quick test records the electrical signals in the heart. It shows how the heart is beating. […] Chest X-ray. A chest X-ray shows the heart and lungs. The test can tell if the heart is larger than usual or if there is fluid around the lungs. Fluid could be due to some types of heart valve disease.

• #9 Heart valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heart-valve-disease/diagnosis-treatment/drc-20353732

  Cardiac MRI. A cardiac MRI uses magnetic fields and radio waves to create detailed images of the heart. It can help determine the severity of heart valve disease. […] Exercise tests or stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the heart is checked. Exercise tests show how the heart responds to physical activity and whether valve disease symptoms occur during exercise. […] Cardiac catheterization. This test isn’t often used to diagnose heart valve disease. But it may be done if other tests can’t diagnose a heart valve problem. Or it might be used to tell how severe heart valve disease is. […] After testing confirms a diagnosis of heart valve disease, your health care team may tell you the stage of disease. Staging helps determine the most appropriate treatment.

• #9 Heart valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/heart-valve-disease/diagnosis-treatment/drc-20353732

  The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs. […] Heart valve disease is staged into four basic groups: […] Stage A: At risk. Risk factors for heart valve disease are present. […] Stage B: Progressive. Valve disease is mild or moderate. There are no heart valve symptoms. […] Stage C: Asymptomatic severe. There are no heart valve symptoms but the valve disease is severe. […] Stage D: Symptomatic severe. Heart valve disease is severe and is causing symptoms.

• #10 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p371.html

  The primary indices of stenosis severity are maximum transaortic velocity and the Doppler-derived mean pressure gradient. […] Classic symptoms of aortic stenosis accompanied by echocardiographic findings consistent with severe stenosis should prompt cardiology consultation. […] Aortic valve replacement is the only effective treatment for symptomatic, hemodynamically severe aortic stenosis. […] Aortic valve replacement is also recommended for asymptomatic patients with severe stenosis accompanied by LV systolic dysfunction (EF less than 50%). […] Watchful waiting is recommended for most asymptomatic patients with aortic stenosis, including those with severe disease. […] Attempts have been made to identify patients who are more likely to have poor outcomes without early aortic valve replacement. […] In patients whose symptom status is unclear, cautious exercise stress testing can objectively assess exercise tolerance or detect an abnormal blood pressure response.

• #10 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p371.html

  Aortic valve replacement is recommended for most symptomatic patients with evidence of significant aortic stenosis on echocardiography. […] In asymptomatic patients, serial Doppler echocardiography is recommended every six to 12 months for severe aortic stenosis, every one to two years for moderate disease, and every three to five years for mild disease. […] Echocardiography is indicated in patients with a loud unexplained systolic murmur, a single second heart sound, a history of a bicuspid aortic valve, or symptoms that may be caused by aortic stenosis. […] Transthoracic echocardiography, the recommended initial test for patients with suspected aortic stenosis, allows reliable identification of the number of valve leaflets and assessment of valve motion, leaflet calcification, and LV function.

• #11 Aortic Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-stenosis/diagnosis

  The diagnosis of aortic stenosis is often made initially on physical examination and confirmed by echocardiography. The ECG findings of left ventricular hypertrophy with strain and left atrial enlargement are non-specific. […] Two-dimensional echocardiography can demonstrate a thickened aortic valve, reduced leaflet mobility and concentric left ventricular hypertrophy. The echocardiogram can also quantify aortic stenosis severity. Transthoracic echocardiography (TTE) can assess the size of the left ventricle, the presence of concurrent aortic or mitral regurgitation, and estimate pulmonary systolic pressure. […] The 2020 ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease categorize aortic stenosis into four stages, including: risk of AS (Stage A), progressive hemodynamic obstruction (Stage B), asymptomatic severe AS (Stage C, with substages C1 and C2), and symptomatic severe AS (Stage D, with substages D1, D2, and D3). The formal criteria for each stage consider valve anatomy, hemodynamics, changes in the left ventricle and vasculature, and the presence or absence of symptoms.

• #11 Aortic Stenosis Topic Review

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/aortic-stenosis/diagnosis

  The velocity of blood flow across the aortic valve, as determined by continuous wave Doppler, is used to calculate the transaortic pressure gradient using the modified Bernoulli equation. […] However, the full formula should be used if V1 is abnormally high ( 1 m/s), such as with obstructive cardiomyopathy. […] Another metric used for assessing AS severity that can be determined using echocardiography is the dimensionless index (DI). This unitless measure is the ratio of left ventricular outflow tract (LVOT) velocity and vena contracta velocity. […] Cardiac catheterization is indicated to determine whether angina may be due to coexistent coronary disease or when aortic valve replacement is indicated. Rarely, left heart catheterization with hemodynamic measurements may be needed if echocardiographic findings are equivocal. […] The mean transaortic valve pressure gradient, not the peak-to-peak gradient, is used in the Gorlin equation to calculate the AVA. […] Once obtained, the anatomic and hemodynamic parameters are used to define each of the four stages of AS, as described below.

• #12 Heart Valve Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease

  During a physical examination, a healthcare provider may find these signs of heart valve disease: […] Several medical tests can also show heart valve disease. Repeating tests over time can help your provider see the progress of your valve disease and make decisions about your treatment. Valve disease can get worse over time. You may hear a provider describe valve disease with a letter for its stage. Stages start with A and end with D, which is the most severe. […] Tests for heart valve disease diagnosis include: Echocardiogram (heart ultrasound) A moving image of your heart using sound waves from a handheld wand placed on your chest […] Transesophageal echocardiogram (TEE) An ultrasound of your heart that uses a probe with a transducer down your esophagus, which sits very close to your heart

• #12 Heart Valve Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease

  Exercise stress echocardiogram A test that shows how your valves and heart function after you walk on a treadmill or ride a bike. […] Chest X-ray A quick X-ray scan of your chest. […] Cardiac catheterization (angiogram) X-ray movies of your coronary arteries, heart chambers and heart valves. […] Electrocardiogram (EKG or ECG) Small electrode patches attached to your skin record your hearts electrical activity. […] Magnetic resonance imaging (MRI) Radio waves and a magnet work together to create high-quality images of your heart.

• #13 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  A transthoracic echocardiogram is a non-invasive ultrasound of the heart that evaluates the hearts structure and function. By placing an ultrasound probe on the chest, soundwaves are used to assess blood flow through the heart and valves. The data from the TTE helps determine the severity of aortic regurgitation. […] Like a TTE, the transesophageal echocardiogram uses ultrasound waves to create detailed images of the hearts structures. However, instead of placing the probe on the chest, a TEE involves inserting the ultrasound probe into the esophagus. This approach provides a more detailed view of the heart, aorta, and surrounding tissues. […] Electrocardiograms record your hearts electrical activity and detect abnormalities like arrhythmias. In cases of aortic valve regurgitation, an EKG can identify left ventricle hypertrophy (thickening of the heart wall) and other underlying heart issues, such as myocardial ischemia.

• #14 Heart Valve Disease Diagnosis | National Jewish Health

  https://www.nationaljewish.org/conditions/heart-valve-disease/diagnosis

  Your doctors can listen for the distinct sounds or murmurs of valve disease with a stethoscope. […] Other tests are usually more specific and include: […] Echocardiography (a sonogram of your heart): This produces a picture of the thickness of your heart’s walls, your valves’ shape and action, and the size of your valve openings. Doppler echocardiography (ultrasound) can be used to determine the severity of the narrowing (stenosis) or backflow (regurgitation). […] Electrocardiography (EKG or ECG): This can be used to find out if your ventricles or atria are enlarged. This test can also determine if you have an irregular heartbeat (arrhythmia). […] Chest X-ray: This can show if your heart is enlarged, which can happen if a valve is not working properly. […] Cardiac Catheterization: This is a minimally invasive way to determine the severity of valvular disease, most often used for stenotic valves. […] Cardiac Magnetic Resonance Imaging (MRI): This can give a 3-dimensional picture of your heart and valves and their function.

• #15 Diagnosing Valve Disease | Adventist Heart Institute

  https://www.adventistheart.org/valve-disease/diagnosing-valve-disease/index.html

  Magnetic resonance imaging (MRI) uses powerful magnet and radio waves to make detailed images of the heart. Cardiac MRI can be used to get a more detailed look at suspected valve problems, or be used by your surgeon to plan for the surgery. […] Cardiac catheterization is a minimally invasive technology where a flexible tube is introduced into a blood vessel in your arm, groin, or neck and threaded to your heart, guided by x-ray images. Your physician conducts tests through the catheter to measure blood pressure within the heart, evaluate heart muscle function, and observe whether the hearts valves are opening and closing fully and efficiently.

• #16 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0915/p717.html

  Watchful waiting until symptoms are detected is appropriate in most patients with asymptomatic aortic stenosis. […] ACC/AHA guidelines recommend that serial Doppler echocardiography be performed annually for severe aortic stenosis, every one to two years for moderate aortic stenosis, and every three to five years for mild aortic stenosis.

• #16 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0915/p717.html

  Aortic valve replacement should be recommended in most patients with any of these symptoms accompanied by evidence of significant aortic stenosis on echocardiography. […] Serial Doppler echocardiography is recommended annually for severe aortic stenosis, every one to two years for moderate disease, and every three to five years for mild disease. […] Doppler echocardiography is the recommended initial test for patients with classic symptoms of aortic stenosis. […] Echocardiography also provides useful information about LV function, left ventricular filling pressure, and coexisting abnormalities of other valves. […] Isolated aortic stenosis rarely becomes symptomatic until the aortic valve area is less than 1 cm2, the mean gradient is greater than 40 mm Hg, or the aortic jet velocity is greater than 4 m per second.

• #16 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0915/p717.html

  It is essential that primary care physicians consider aortic stenosis in adults who present with any of the classic symptoms accompanied by a systolic murmur. […] American College of Cardiology/American Heart Association (ACC/AHA) practice guidelines recommend echocardiography in asymptomatic patients with a grade 3/6 or louder systolic murmur. […] In symptomatic patients with echocardiographic measures consistent with severe aortic stenosis, symptoms must be presumed to be a result of aortic stenosis, even if other potentially causative conditions, such as CAD, are present. […] Aortic valve replacement is also recommended for asymptomatic patients with severe aortic stenosis accompanied by LV systolic dysfunction (i.e., ejection fraction of less than 50 percent). […] When severe aortic stenosis is shown to be the primary pathology in this setting, aortic valve replacement is a lifesaving therapy and improves LV function.

• #17 Artificial intelligence in heart valve disease: diagnosis, innovation and treatment. A state-of-the-art review

  https://bjcardio.co.uk/2024/08/artificial-intelligence-in-heart-valve-disease-diagnosis-innovation-and-treatment-a-state-of-the-art-review/

  In recent years, artificial intelligence (AI) has been used to improve the precision of valvular heart disease diagnosis and treatment. […] AI has been used to improve the precision of valvular heart disease diagnosis by enhancing the recognition of abnormalities in clinical examination, electrocardiography (ECG) and echocardiography. […] AI can help to guide the treatment of patients with valvular heart disease, by aiding in optimal device selection for transcatheter valvular interventions and, potentially, predicting the risk of specific complications. […] AI has also emerged as a useful tool in the interpretation of ECGs. […] The area under the curve (AUC) was 0.86, with a sensitivity of 80% and specificity of 78.3%. […] AI interpretation of echocardiographic images has also been shown to improve diagnostic accuracy in valvular heart disease when compared with traditional analysis.

• #17 Artificial intelligence in heart valve disease: diagnosis, innovation and treatment. A state-of-the-art review

  https://bjcardio.co.uk/2024/08/artificial-intelligence-in-heart-valve-disease-diagnosis-innovation-and-treatment-a-state-of-the-art-review/

  A number of machine-learned prediction models designed to accurately assess the risk of post-procedural mortality have been developed in the past decade, and in some cases these have been shown to be better able to predict mortality following valvular heart disease intervention than traditional scoring systems. […] As hospitals increasingly move towards electronic patient databases, AI provides the potential to develop individualised risk-prediction models based on specific patient characteristics, allowing clinicians to choose the optimal treatment strategy in a more nuanced way than is currently possible. […] While a number of the AI models described so far in this paper have the potential to aid diagnosis and treatment of valvular heart disease in the future, some forms of AI are already being used relatively routinely.

• #18 Clinical manifestations and diagnosis of aortic stenosis in adults – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-aortic-stenosis-in-adults

  Patients with nondiagnostic noninvasive evaluation […] Patients with a concurrent indication for coronary angiography […] Asymptomatic sedentary patients […] Patients with equivocal symptoms […] Patients with low gradient aortic stenosis […] Cardiovascular magnetic resonance […] Positron emission tomography.

• #18 Clinical manifestations and diagnosis of aortic stenosis in adults – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-aortic-stenosis-in-adults

  Clinical manifestations and diagnosis of aortic stenosis in adults […] Aortic valve stenosis is the most common cause of left ventricular (LV) outflow obstruction in children and adults; less common causes are subvalvular or supravalvular disease (table 1). This topic will review the clinical features, diagnosis, and evaluation of valvular aortic stenosis (AS) […] Symptoms — The most common presenting symptoms in patients with severe AS are: […] Dyspnea on exertion or decreased exercise tolerance […] Exertional dizziness (presyncope) or syncope […] Initial approach to diagnosis and evaluation — Point-of-care ultrasound […] Diagnostic echocardiography […] Assessment of disease stages […] Other initial tests […] Role of serial evaluation […] Additional testing based on clinical presentation

• #19 Heart Valve Disease Diagnosis – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/heart-vascular/valve-disease/diagnosis

  Early diagnosis is crucial for effectively treating and managing serious heart conditions. […] We use the latest, most advanced technology to identify the underlying cause of the valve or structural heart disease. […] Echocardiograms are painless tests that use sound waves to show the heart’s structure and function. […] Computed tomography (CT) is a non-invasive diagnostic tool that provides a detailed image of the heart. […] Magnetic resonance imaging provides a detailed look at the beating heart. […] Nuclear imaging studies are tests that study blood flow and heart function through the use of sophisticated molecular imaging tools and radionuclide dyes. […] Cardiac catheterization is a minimally invasive procedure used to evaluate heart functionality. […] Heart experts at the University of Chicago Heart and Vascular Imaging Center diagnose heart and blood vessel problems using the most advanced noninvasive and minimally invasive approaches.

• #20 Aortic Valve Disease | UNC Heart Valve Clinic

  https://www.med.unc.edu/medicine/cardiology/uncheartvalve/diseases-and-treatments/aortic-valve-disease/

  Aortic valve stenosis occurs when the opening of the aortic valve becomes narrowed and the valve no longer opens fully with each heartbeat. […] When symptoms, such as shortness of breath or chest pain, develop from aortic stenosis, the average life expectancy is only 1-2 years, with a prognosis that is worse than most cancers, if left untreated. […] Unfortunately, at least 1/3 of patients with aortic valve stenosis today are not receiving valve replacement, which is the only treatment that is effective for this condition. […] Transcatheter aortic valve replacement (TAVR) is an alternate treatment option to conventional open heart surgery, and TAVR has shown to have equal, and sometimes better outcomes than traditional surgery. […] TAVR is now an option for patients in all risk categories including inoperable, high, intermediate, and low surgical risk.

• #21 Aortic Valve Insufficiency: Causes, Symptoms & Diagnosis

  https://www.healthline.com/health/aortic-insufficiency

  Your treatment may also include addressing the underlying cause. […] People with aortic insufficiency who receive treatment typically have a good outlook. […] If your condition does not require surgery, doctors may recommend echocardiography exams every few years or more often. […] Aortic valve insufficiency is a valvular heart disease that means that your aortic valve doesnt fully close. […] Treatment can depend on the severity of the aortic valve insufficiency and may require lifestyle changes and monitoring or surgery.

• #22 Heart valve disease module 4: diagnosis – The British Journal of Cardiology

  https://bjcardio.co.uk/2016/03/heart-valve-disease-module-4-diagnosis-2/

  The mainstay of diagnosis in heart valve disease is imaging, using transthoracic echocardiography. This module describes the information required from echocardiography to diagnose heart valve disease and inform decisions about further management. […] The echocardiographic minimum dataset for aortic stenosis consists of: a detailed description of the valve appearance and mobility, Doppler parameters including peak velocity, mean gradient, and effective orifice area (EOA) calculated using the continuity equation. […] The cut-offs for grading can be found in table 1. Discrepancies are common and are usually caused by: incorrect measurements, high or low flow, extremes of body size. […] The key to resolving the discrepancies is to look at the valve and the waveform shape. […] If the valve does not open well, look at the LV and check the velocity-time integral (VTI). If the ejection fraction (EF) is 40% or the VTI is low (15 cm), this is low flow AS. A stress echocardiogram should be considered.

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