Choroba zastawki aorty
Zapobieganie i profilaktyka
Choroba zastawki aorty, choć częściowo uwarunkowana genetycznie i związana z procesem starzenia, może być profilaktycznie modyfikowana poprzez kontrolę czynników ryzyka sercowo-naczyniowego. Kluczowe działania obejmują utrzymanie prawidłowego ciśnienia tętniczego, poziomu cholesterolu LDL, glukozy oraz lipoproteiny(a), co zmniejsza ryzyko kalcyfikacji i degeneracji zastawki. Profilaktyka infekcyjnego zapalenia wsierdzia wymaga dbałości o higienę jamy ustnej oraz indywidualnego rozważenia antybiotykoterapii u pacjentów wysokiego ryzyka (amoksycylina 3 g p.o. 1 h przed zabiegiem lub klindamycyna 600 mg p.o. u osób z alergią na penicyliny). Wczesne leczenie paciorkowcowych infekcji gardła i długoterminowa antybiotykoterapia profilaktyczna u chorych po przebytym gorączce reumatycznej są niezbędne dla zapobiegania uszkodzeniom zastawki.
- Profilaktyka choroby zastawki aorty
- Zdrowy styl życia
- Kontrola czynników ryzyka sercowo-naczyniowego
- Profilaktyka infekcyjnego zapalenia wsierdzia
- Profilaktyka i leczenie gorączki reumatycznej
- Regularne badania kontrolne
- Farmakoterapia w profilaktyce
- Ograniczenia aktywności fizycznej
- Podsumowanie profilaktyki choroby zastawki aorty
Profilaktyka choroby zastawki aorty
Choroba zastawki aorty jest schorzeniem, którego ryzyko wystąpienia można częściowo zredukować poprzez odpowiednie działania profilaktyczne. Chociaż nie wszystkie przypadki choroby zastawki aorty można zapobiec (szczególnie te związane z wrodzonymi wadami serca czy procesem starzenia), istnieje wiele strategii, które mogą zmniejszyć ryzyko jej rozwoju lub spowolnić jej postęp.123
Zdrowy styl życia
Profilaktyka choroby zastawki aorty w dużej mierze opiera się na prowadzeniu zdrowego stylu życia, który obejmuje:456
- Regularną aktywność fizyczną zgodną z wytycznymi dla zdrowia serca
- Zdrową dietę bogatą w świeże owoce i warzywa
- Utrzymywanie prawidłowej masy ciała
- Rezygnację z palenia tytoniu
- Ograniczenie spożycia alkoholu
- Zarządzanie stresem
Kontrola czynników ryzyka sercowo-naczyniowego
Regularne monitorowanie i kontrola czynników ryzyka chorób sercowo-naczyniowych jest kluczowym elementem w zapobieganiu rozwojowi choroby zastawki aorty. Do najważniejszych działań należą:1011
- Kontrola ciśnienia tętniczego – nadciśnienie tętnicze jest jednym z najistotniejszych czynników ryzyka choroby zastawki aorty, zwiększając obciążenie serca i przyspieszając degenerację zastawki. Badania wskazują, że długotrwale podwyższone ciśnienie krwi zwiększa ryzyko zarówno stenozy, jak i niedomykalności zastawki aorty.1213
- Kontrola poziomu cholesterolu – wysokie stężenie cholesterolu, szczególnie LDL, może przyczyniać się do kalcyfikacji zastawki aorty. Badania sugerują, że obniżenie poziomu cholesterolu we wczesnych stadiach choroby może zapewnić ochronę przed rozwojem choroby zastawki aorty.141516
- Kontrola poziomu glukozy we krwi – cukrzyca może przyczynić się do rozwoju choroby zastawki aorty i przyspieszyć jej postęp poprzez wywoływanie stanu zapalnego i promowanie akumulacji wapnia w zastawce.1718
- Utrzymywanie prawidłowego poziomu lipoproteiny(a) – badania wskazują, że wysoki poziom lipoproteiny(a) jest czynnikiem ryzyka rozwoju wapniejącej choroby zastawki aorty (CAVD). Zmniejszenie stężenia lipidów takich jak lipoproteina(a) może być skuteczne w zapobieganiu mineralizacji zastawki aorty.1920
Profilaktyka infekcyjnego zapalenia wsierdzia
Infekcyjne zapalenie wsierdzia może prowadzić do uszkodzenia zastawki aorty. Pacjenci z chorobą zastawki aorty są bardziej narażeni na to powikłanie. Profilaktyka obejmuje:2122
- Dbanie o higienę jamy ustnej – regularne mycie zębów, nitkowanie i wizyty u stomatologa co 6 miesięcy mogą zmniejszyć ryzyko zapalenia dziąseł (gingivitis), które może prowadzić do infekcji serca.232425
- Antybiotykoterapia profilaktyczna – według aktualnych wytycznych, profilaktyka antybiotykowa przed zabiegami stomatologicznymi i chirurgicznymi nie jest rutynowo zalecana wszystkim pacjentom, ale może być rozważana indywidualnie u pacjentów wysokiego ryzyka, takich jak osoby z protezami zastawkowymi, z wcześniejszymi epizodami zapalenia wsierdzia lub określonymi wrodzonymi wadami serca.2627
W przypadku zalecenia profilaktyki, stosuje się amoksycylinę 3 g doustnie na godzinę przed zabiegiem, a u pacjentów z nadwrażliwością na penicylinę – klindamycynę 600 mg doustnie.28
Profilaktyka i leczenie gorączki reumatycznej
Gorączka reumatyczna może prowadzić do uszkodzenia zastawek serca, w tym zastawki aorty. Profilaktyka obejmuje:29
- Właściwe leczenie infekcji paciorkowcowych – odpowiednio wczesne rozpoznanie i leczenie antybiotykami paciorkowcowego zapalenia gardła i migdałków, aby zapobiec gorączce reumatycznej.3031
- Długoterminowa antybiotykoterapia-profilaktyczna/” title=”antybiotykoterapia profilaktyczna” class=”to-tag” data-termid=”18257″>antybiotykoterapia profilaktyczna – u osób, które przebyły gorączkę reumatyczną, aby zapobiec nawrotom i dalszemu uszkodzeniu zastawek.32
Regularne badania kontrolne
Wczesne wykrycie choroby zastawki aorty jest kluczowe dla skutecznego zarządzania schorzeniem. Regularne badania kontrolne powinny obejmować:3334
- Regularne wizyty lekarskie z osłuchiwaniem serca przy pomocy stetoskopu
- Informowanie lekarza o zauważonych zmianach w rytmie serca lub pojawieniu się objawów
- W przypadku wykrycia nieprawidłowości – odpowiednie badania diagnostyczne, takie jak echokardiografia
Farmakoterapia w profilaktyce
Chociaż obecnie nie ma specyficznej terapii farmakologicznej, która mogłaby zapobiec rozwojowi choroby zastawki aorty, niektóre leki mogą być stosowane w celu kontroli czynników ryzyka i łagodzenia objawów:3738
- Leki obniżające cholesterol – szczególnie statyny, mogą być rozważane we wczesnych stadiach choroby zastawki aorty, aby spowolnić jej postęp.3940
- Inhibitory układu renina-angiotensyna-aldosteron (RAAS) – zalecane jako główna terapia u pacjentów ze stenozą aorty i współistniejącym nadciśnieniem tętniczym.41
- Leki przeciwnadciśnieniowe (inhibitory ACE, beta-blokery) – pomagają kontrolować ciśnienie krwi i zmniejszać obciążenie serca.42
- Leki przeciwarytmiczne – pomagają utrzymać regularny rytm serca.43
- Leki przeciwzakrzepowe – mogą być stosowane w celu zapobiegania powstawaniu zakrzepów.44
- Diuretyki – mogą pomóc zmniejszyć zatrzymywanie płynów.45
Ograniczenia aktywności fizycznej
U pacjentów z ciężką stenozą zastawki aorty (pole powierzchni <1,0 cm²) zaleca się unikanie intensywnego wysiłku fizycznego, w tym podnoszenia ciężarów i innych aktywności, które zwiększają obciążenie następcze, ze względu na ryzyko niedokrwienia mięśnia sercowego i nagłej śmierci sercowej.46
Podsumowanie profilaktyki choroby zastawki aorty
Choć nie wszystkim przypadkom choroby zastawki aorty można zapobiec, szczególnie tym związanym z wrodzonymi wadami serca czy procesem starzenia, stosowanie kompleksowych strategii profilaktycznych może znacząco zmniejszyć ryzyko jej rozwoju lub spowolnić jej postęp. Kluczowe znaczenie ma prowadzenie zdrowego stylu życia, kontrola czynników ryzyka sercowo-naczyniowego, odpowiednia profilaktyka infekcyjnego zapalenia wsierdzia i gorączki reumatycznej oraz regularne badania kontrolne.4748
Badania nad nowymi metodami zapobiegania chorobie zastawki aorty, w tym farmakoterapią ukierunkowaną na specyficzne mechanizmy jej rozwoju, trwają i mogą przynieść nowe możliwości profilaktyczne w przyszłości.4950
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Materiały źródłowe
- #1 Aortic valve stenosis – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/aortic-stenosis/symptoms-causes/syc-20353139
Some possible ways to prevent aortic valve stenosis are: […] Get a health checkup when you have a sore throat. Strep throat that is not treated can lead to rheumatic fever, which can damage heart valves. Strep throat can usually be easily treated with antibiotics. Rheumatic fever is more common in children and young adults. […] Keep the heart healthy. Talk about your risk factors for heart disease with your healthcare team. Ask how to prevent and manage them. Risk factors such as high blood pressure, obesity and high cholesterol may be linked to aortic valve stenosis. […] Take care of the teeth and gums. There may be a link between infected gums, called gingivitis, and a heart infection known as endocarditis. Endocarditis is a risk factor for aortic valve stenosis.
- #2 Aortic Valve Disease/Heart Valve Disease: Types, Symptoms, & Causes | University of Utah Healthhttps://healthcare.utah.edu/cardiovascular/programs/aortic-disease/aortic-valve-disease
If you develop aortic valve disease because of a congenital heart defect, you cannot prevent the disease. However if you dont have a congenital heart defect, there are some steps you can take to reduce the risk of developing aortic valve disease. […] Take antibiotics when you have strep throat to prevent rheumatic fever. Strep throat can be easily tested at your doctors office and antibiotics can usually treat this disease quickly and effectively. This will help you avoid complications that can lead to rheumatic fever and heart damage. […] Reduce your risk of heart disease by: keeping your blood pressure under control, managing diabetes appropriately, maintaining healthy cholesterol levels (and having your cholesterol checked regularly), and maintaining a healthy body weight to avoid obesity.
- #3 What Is Aortic Valve Disease?https://my.clevelandclinic.org/health/diseases/24452-aortic-valve-disease
How can I prevent aortic valve disease? It’s not always possible to prevent aortic valve disease. It often occurs due to aging, congenital heart disease or chronic conditions. However, you can lower your risk and keep your heart valves healthy by: […] Seeing your doctor regularly in follow-up so that if you’re developing valve disease, it can be treated appropriately.
- #4 Heart Valve Diseases – Causes and Risk Factors | NHLBI, NIHhttps://www.nhlbi.nih.gov/health/heart-valve-diseases/causes
You can take steps to help prevent some causes of congenital heart valve disease, although not all are preventable. Talk to your doctor about any vitamins you may need and how to avoid infections such as rubella during pregnancy. […] Your doctor may also talk to you about steps you can take to lower your risk for acquired heart valve diseases. […] Make heart-healthy lifestyle changes. These include eating a heart-healthy diet, being physically active, aiming for a healthy weight, quitting smoking, and managing stress. […] Practice good skin and dental hygiene. This can help protect you from infections that cause endocarditis, a type of heart inflammation that can damage the heart valves. […] Take medicines as prescribed to prevent a heart attack, high blood pressure, or heart failure. If you have strep throat, finish all of your prescribed medicine to treat it. This helps prevent rheumatic fever, which can damage the heart valves.
- #5 Heart Valve Disease Prevention | Vital Heart & Veinhttps://vitalheartandvein.com/news/heart-valve-disease-prevention/
Heart valve disease is more common in those over the age of 55. […] You can start by visiting your doctor and maintaining regular checkups. […] You should also cultivate a heart healthy lifestyle including regular physical activity and a balanced diet. […] There are some medicines aimed at preventing heart valve disease by improving blood flow, lowering cholesterol, and alleviating symptoms of heart disease. […] If you are interested in learning more about your own heart health, or heart valve disease prevention, take a look at both our physicians and procedures offered through our services at Vital Heart Vein. Through regular checkups, a nutritious diet, and consistent exercise, you can help do your best to keep your heart healthy.
- #6 About Heart Valve Disease | Heart Disease | CDChttps://www.cdc.gov/heart-disease/about/heart-valve-disease.html
People may help to reduce their risk for heart valve disease by: […] Making heart-healthy choices by: […] Choosing heart-healthy foods, such as fresh fruits and vegetables. […] Following CDC physical activity guidelines for heart health. […] Managing stress. […] Getting to know your heart health by: […] Getting annual physical checkups, including having a health care professional listen to your heart with a stethoscope. […] Letting your health care team know if you have noticed changes in your heartbeat. […] Taking care of your overall health by: […] Having a good daily oral hygiene routine and getting regular dental checkups to reduce risk of heart infection. […] Getting treatment for respiratory infections such as strep throat. […] Taking antibiotics as instructed to prevent infection (such as when they are prescribed before surgery or dental procedures).
- #7 How to strengthen heart valves: Diet, exercise, and morehttps://www.medicalnewstoday.com/articles/how-to-strengthen-heart-valves-naturally
Individuals can help strengthen their heart valves through dietary changes, regular exercise, and managing blood pressure. […] Problems with these valves can develop over time. However, appropriate lifestyle modifications can help maintain strong heart valves. […] The CDC also recommends limiting salt and alcohol intake to control blood pressure, which can damage the heart valves. […] The CDC also notes that regular exercise is important for preventing heart disease. […] A 2018 study of 5.4 million United Kingdom adults found that long-term elevated blood pressure increases a persons risk for aortic valve stenosis or aortic valve regurgitation. […] High blood pressure increases someones risk for coronary heart disease and stroke. […] A person can help keep their heart valves in healthy working order by following the above health tips, including: eating a nutritious diet, getting daily, moderate-intensity exercise, keeping blood pressure in check, avoiding smoking, if applicable.
- #8 Overview of Valvular Heart Disease | Pantai Hospitalhttps://www.pantai.com.my/medical-specialties/cardiology/valvular-heart-disease
Lower your risk by leading a healthy lifestyle. Follow these simple tips: […] Quit smoking […] Get physically active […] Maintain a healthy weight […] Eat a healthy diet […] Reduce alcohol consumption […] Manage your stress.
- #9 Heart Valve Disease | University of Ottawa Heart Institutehttps://www.ottawaheart.ca/heart-condition/heart-valve-disease
Some risk factors for developing heart valve disease are the same as other heart conditions and can be reduced with lifestyle changes or with early detection and medication. To prevent heart disease in general, it is important to: […] Quit smoking […] Get your cholesterol checked and under control […] Eat a healthy diet […] Exercise regularly […] Lose weight if you are overweight.
- #10 Aortic Valve Disease/Heart Valve Disease: Types, Symptoms, & Causes | University of Utah Healthhttps://healthcare.utah.edu/cardiovascular/programs/aortic-disease/aortic-valve-disease
If you develop aortic valve disease because of a congenital heart defect, you cannot prevent the disease. However if you dont have a congenital heart defect, there are some steps you can take to reduce the risk of developing aortic valve disease. […] Take antibiotics when you have strep throat to prevent rheumatic fever. Strep throat can be easily tested at your doctors office and antibiotics can usually treat this disease quickly and effectively. This will help you avoid complications that can lead to rheumatic fever and heart damage. […] Reduce your risk of heart disease by: keeping your blood pressure under control, managing diabetes appropriately, maintaining healthy cholesterol levels (and having your cholesterol checked regularly), and maintaining a healthy body weight to avoid obesity.
- #11 Can Aortic Stenosis Be Prevented? | Cardiovascular Disease Specialists located in Riverside, CA | Syed Bokhari, MD, FACChttps://www.acvcare.com/post/can-aortic-stenosis-be-prevented
Aortic stenosis is like many chronic health conditions it develops for years without causing symptoms. […] Thats why our team at Advanced Cardiovascular Care encourages you to take care of your health and take steps to eliminate the problems that increase your risk of aortic stenosis. […] Preventing aortic stenosis is an area actively being studied, but we know that specific health problems increase your risk for aortic valve narrowing. Eliminating your risk factors influences the health of your aortic valve. […] Since aortic stenosis develops over decades, youll need to follow lifelong habits that protect your overall health and prevent chronic diseases, especially those that contribute to aortic stenosis. […] High blood pressure (hypertension) increases your risk of aortic stenosis. In fact, of all the known risk factors, it has the most significant influence.
- #12 Can Aortic Stenosis Be Prevented? | Cardiovascular Disease Specialists located in Riverside, CA | Syed Bokhari, MD, FACChttps://www.acvcare.com/post/can-aortic-stenosis-be-prevented
Aortic stenosis is like many chronic health conditions it develops for years without causing symptoms. […] Thats why our team at Advanced Cardiovascular Care encourages you to take care of your health and take steps to eliminate the problems that increase your risk of aortic stenosis. […] Preventing aortic stenosis is an area actively being studied, but we know that specific health problems increase your risk for aortic valve narrowing. Eliminating your risk factors influences the health of your aortic valve. […] Since aortic stenosis develops over decades, youll need to follow lifelong habits that protect your overall health and prevent chronic diseases, especially those that contribute to aortic stenosis. […] High blood pressure (hypertension) increases your risk of aortic stenosis. In fact, of all the known risk factors, it has the most significant influence.
- #13 Elevated blood pressure is linked to increased risk of aortic valve disease: analysis of 5.4 million adultshttps://www.escardio.org/The-ESC/Press-Office/Press-releases/elevated-blood-pressure-is-linked-to-increased-risk-of-aortic-valve-disease-ana
People who have long-term raised blood pressure have an increased risk of aortic valve disease (AVD) problems with the valve that controls how blood is pumped from the left ventricle of the heart out into the main artery, the aorta. […] The findings suggest that controlling blood pressure, even at levels below the threshold currently defined for hypertension of 140/90 mmHg, may be a way to prevent these conditions. […] These findings collectively suggest that AS and AR might be partially preventable with potential implications on clinical practice guidelines for prevention of cardiovascular disease in general and valvular heart disease and hypertension in particular, write the authors of the EHJ paper. […] Long-term exposure to higher blood pressure is a strong and potentially modifiable risk factor for aortic stenosis and regurgitation at every level of typical blood pressure, not only in those who are classified as having hypertension.
- #14 Key to aortic valve disease prevention | Newsroom – McGill Universityhttps://www.mcgill.ca/newsroom/channels/news/key-aortic-valve-disease-prevention-239812
Lowering cholesterol early is a key to aortic valve disease prevention […] Our work provides confirmation that cholesterol is an important factor in the early stages of aortic valve disease and suggests that lowering cholesterol early in the disease process may provide protection from the development of aortic valve disease. […] Our next step calls for new randomized trials, maybe using one of several new LDL lowering agents, in the earliest stages of valve disease before we are able to confirm our hypothesis.
- #15 Key to aortic valve disease prevention: Lowering cholesterol early | ScienceDailyhttps://www.sciencedaily.com/releases/2014/10/141027120501.htm
Nowe dowody wskazujÄ , że choroba zastawki aortalnej może byÄ zapobiegana. […] Nasza praca potwierdza, że cholesterol jest ważnym czynnikiem we wczesnych stadiach choroby zastawki aortalnej i sugeruje, że obniżenie cholesterolu we wczesnym etapie procesu chorobowego może zapewniÄ ochronÄ przed rozwojem choroby zastawki aortalnej. […] Nasz nastÄpny krok wymaga nowych randomizowanych badaÅ, byÄ może z wykorzystaniem jednego z kilku nowych Årodków obniżajÄ cych LDL, we wczesnych stadiach choroby zastawki, zanim bÄdziemy mogli potwierdziÄ naszÄ hipotezÄ.
- #16 Research reveals link between high cholesterol levels and risk of aortic valve disease | University of Oxfordhttps://www.ox.ac.uk/news/2020-02-20-research-reveals-link-between-high-cholesterol-levels-and-risk-aortic-valve-disease
’Until recently, aortic stenosis has been widely considered a degenerative disorder associated with ageing with no recommended medical guidance for its prevention. […] Crucially, the evidence that high cholesterol is a risk factor for aortic stenosis presents clinicians with an opportunity to modify disease risk via preventative measures, for instance through the use of cholesterol-lowering medications such as statin therapy.’
- #17 Can Aortic Stenosis Be Prevented? | Cardiovascular Disease Specialists located in Riverside, CA | Syed Bokhari, MD, FACChttps://www.acvcare.com/post/can-aortic-stenosis-be-prevented
Its also estimated that 40% of patients diagnosed with aortic stenosis have hypertension, which increases the amount of stress on your heart as it works to pump blood. […] High cholesterol and high blood levels of triglycerides boost your chance of developing aortic stenosis. […] Smoking has a big influence of the development of atherosclerosis in your coronary arteries; its also closely associated with a higher risk of aortic stenosis. […] Diabetes contributes to aortic stenosis and may hasten its progression. We believe that it affects your heart valve by triggering inflammation and promoting calcium accumulation.
- #18 Aortic Valve Disease/Heart Valve Disease: Types, Symptoms, & Causes | University of Utah Healthhttps://healthcare.utah.edu/cardiovascular/programs/aortic-disease/aortic-valve-disease
If you develop aortic valve disease because of a congenital heart defect, you cannot prevent the disease. However if you dont have a congenital heart defect, there are some steps you can take to reduce the risk of developing aortic valve disease. […] Take antibiotics when you have strep throat to prevent rheumatic fever. Strep throat can be easily tested at your doctors office and antibiotics can usually treat this disease quickly and effectively. This will help you avoid complications that can lead to rheumatic fever and heart damage. […] Reduce your risk of heart disease by: keeping your blood pressure under control, managing diabetes appropriately, maintaining healthy cholesterol levels (and having your cholesterol checked regularly), and maintaining a healthy body weight to avoid obesity.
- #19 Calcific aortic valve disease: mechanisms, prevention and treatment | Nature Reviews Cardiologyhttps://www.nature.com/articles/s41569-023-00845-7
Risk factors for calcific aortic valve disease (CAVD) include age, male sex, genetics, hypertension, smoking, diabetes mellitus, obesity, high plasma lipoprotein(a) levels and bicuspid aortic valve. […] Evidence suggests that decreasing the plasma levels of lipids such as lipoprotein(a) might be most effective for preventing the onset of aortic valve mineralization. […] Advances in data science together with multimodal tissue-based and single-cell genomic datasets will be key for future research into CAVD.
- #20 Calcific aortic valve disease: mechanisms, prevention and treatment – PubMedhttps://pubmed.ncbi.nlm.nih.gov/36829083/
Calcific aortic valve disease (CAVD) is the most common disorder affecting heart valves and is characterized by thickening, fibrosis and mineralization of the aortic valve leaflets. […] Age and congenital bicuspid aortic valve morphology are important and unalterable risk factors for CAVD, whereas additional risk is conferred by elevated blood pressure and plasma lipoprotein(a) levels and the presence of obesity and diabetes mellitus, which are modifiable factors. […] Although no medical therapy is effective for reducing or preventing the progression of CAVD, studies have started to identify actionable targets.
- #21 Heart Valve Disease: Symptoms & Treatmenthttps://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease
How can I reduce my risk of heart valve disease? Although you cant change some risk factors, like growing older, there are things you can do that may reduce your risk of heart valve disease. These include: […] If you have heart valve disease, ask your healthcare provider about the increased risk of getting infective endocarditis. This infection can damage or destroy your heart valves and can be fatal. Youre at risk even if you had surgery to repair or replace your valve. To prevent infective endocarditis:
- #22 Aortic stenosis precautions and prophylaxis – wikidochttps://www.wikidoc.org/index.php/Aortic_stenosis_precautions_and_prophylaxis
Aortic stenosis of any etiology is associated with a higher rate of infection of the stenosed valve, i.e. infective endocarditis. The American Heart Association recommended that prophylaxis against infective endocarditis be limited only to patients with either prosthetic heart valves, previous episode(s) of endocarditis, or with certain types of congenital heart disease. Patients with severe aortic stenosis should avoid strenuous exercise and any exercise that greatly increases afterload such as weight lifting. […] To reduce the risk of developing infective endocarditis among high-risk patients, antibiotic prophylaxis should be considered prior to certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of esophageal varices, dilation of esophageal strictures, gastrointestinal surgery where the intestinal mucosa will be disrupted, prostate surgery, urethral stricture dilation, and cystoscopy. […] Given the risk of myocardial ischemia and sudden cardiac death, patients with severe aortic stenosis ( 1.0 cm2) should avoid strenuous physical activity including weightlifting and other activities that increase afterload.
- #23 Aortic valve stenosis – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/aortic-stenosis/symptoms-causes/syc-20353139
Some possible ways to prevent aortic valve stenosis are: […] Get a health checkup when you have a sore throat. Strep throat that is not treated can lead to rheumatic fever, which can damage heart valves. Strep throat can usually be easily treated with antibiotics. Rheumatic fever is more common in children and young adults. […] Keep the heart healthy. Talk about your risk factors for heart disease with your healthcare team. Ask how to prevent and manage them. Risk factors such as high blood pressure, obesity and high cholesterol may be linked to aortic valve stenosis. […] Take care of the teeth and gums. There may be a link between infected gums, called gingivitis, and a heart infection known as endocarditis. Endocarditis is a risk factor for aortic valve stenosis.
- #24 Aortic Valve Disease/Heart Valve Disease: Types, Symptoms, & Causes | University of Utah Healthhttps://healthcare.utah.edu/cardiovascular/programs/aortic-disease/aortic-valve-disease
Take care of your teeth and gums. There is increasing evidence that having healthy teeth and gums and avoiding gingivitis can reduce the risk of endocarditis, which is an infection in heart tissue that could damage the aortic valve. […] Brushing and flossing daily and seeing your dentist every six months for a cleaning and checkup can reduce your risk of developing gum disease.
- #25 Preventionhttp://www.cardiosmart.org/topics/aortic-stenosis/prevention
There are steps you can take to strengthen your heart and guard against developing aortic stenosis. These include: […] Make heart-healthy choices: Although not proved, factors that can cause calcium buildup in the arteries of the heart (called atherosclerosis) also can cause calcium buildup on the aortic valve. […] Keep up with dental checkups: Infection in your gums can sometimes cause an infection of the heart valves and cause aortic stenosis. […] Treat infections: The bacteria that cause strep throat can sometimes cause rheumatic fever if left untreated. Rheumatic fever often happens in children and young adults and can be easily treated with antibiotics. If rheumatic fever is not treated, it can cause aortic stenosis years later.
- #26 British Heart Valve Society update: a change in the NICE guidelines on antibiotic prophylaxis – The British Journal of Cardiologyhttps://bjcardio.co.uk/2016/08/british-heart-valve-society-update-a-change-in-the-nice-guidelines-on-antibiotic-prophylaxis/
The National Institute for Health and Care Excellence (NICE) has made an important change to Clinical Guideline 64 (CG64)1 adding the word routinely to Recommendation 1.1.3: Antibiotic prophylaxis against infective endocarditis is not recommended routinely for people undergoing dental procedures. In a letter about the change,2 Sir Andrew Dillon, CEO of NICE, confirmed that in individual cases, antibiotic prophylaxis may be appropriate. […] It is now necessary for dentists to appraise their patient of the differences between NICE and other guidelines, if it is likely that they would have a special interest, for example if they have a replacement heart valve or prior IE.8 Their general practitioner or cardiologist could consider advising the patient and their dentist on the level of risk in a letter. The patient should then be allowed to make up their own mind whether or not to have antibiotic prophylaxis. General Medical Council (GMC)/General Dental Council (GDC) standards and the advice of the medical/dental defence organisations highlight the need for this discussion (and the patients decision) to be recorded in the clinical records.
- #27 Bicuspid Aortic Valve Medicationhttps://emedicine.medscape.com/article/893523-medication
Patients with bicuspid aortic valve are at increased risk for infective endocarditis. Prophylactic antibiotics are no longer required for dental or surgical procedures as recommended by the American Heart Association in 2007 but are recommended to prevent recurrence if an episode of endocarditis has occurred, prosthetic heart valve placed or for 6-months after complete repair of congenital heart defects. […] [Guideline] Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007 Oct 9. 116(15):1736-54. […] [Guideline] Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015 Oct 13. 132(15):1435-86.
- #28 British Heart Valve Society update: a change in the NICE guidelines on antibiotic prophylaxis – The British Journal of Cardiologyhttps://bjcardio.co.uk/2016/08/british-heart-valve-society-update-a-change-in-the-nice-guidelines-on-antibiotic-prophylaxis/
Prophylaxis should be with amoxicillin 3 g by mouth one hour before the procedure or, for patients with penicillin hypersensitivity, clindamicin 600 mg orally. Adverse effects from oral amoxicillin prophylaxis are uncommon with no deaths reported in Europe since records began.8 Clindamicin has a slightly higher level of risk.9 Both are cost-effective in high-risk patients having high-risk dental procedures.8 […] Staff in general practices and specialist valve clinics should emphasise that good oral hygiene and regular dental review are as important as antibiotic prophylaxis, if not more so, in reducing the risk of IE. The European Society of Cardiology (ESC) recommend10 strict dental and cutaneous hygiene with regular dental surveillance. It is also important to educate patients at risk in recognising the possibility of IE. Typically, there may be persistent night sweats, general malaise and weight loss. At least two sets of blood cultures should be taken before starting antibiotics. The British Heart Foundation produce warning cards that can be given to patients available at: https://www.bhf.org.uk/publications/heart-conditions/m26a-endocarditis-card.
- #29 Prevention of aortic valve disease: between doubts and certaintieshttps://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-18/prevention-of-aortic-valve-disease-between-doubts-and-certainties
Aortic valve disease and its prevention is a topic in constant evolution. Currently, medical therapy able to prevent the development of aortic valve disease is not available. […] Prevention also includes avoidance of rheumatic fever and endocarditis. […] Possible prevention strategies have been analysed in the literature. […] Medical therapy, cardiovascular risk factors and prevention of pathologies, such as rheumatic fever and endocarditis, are the most interesting fields which have been investigated in terms of prevention. […] Prevention of rheumatic heart disease means the prevention of the first attack of acute rheumatic fever. […] The objective of primary prevention is the proper identification and adequate antibiotic treatment of group A beta-haemolytic streptococcal tonsillopharyngitis. […] Prevention measures are based on good daily dental hygiene, using optimal quality toothbrushes, and dental follow-up. […] Prophylaxis for rheumatic fever and endocarditis must be performed according to the current indication to avoid the risk of consequent valvular diseases.
- #30 Aortic valve stenosis – Symptoms and causes – Mayo Clinichttps://www.mayoclinic.org/diseases-conditions/aortic-stenosis/symptoms-causes/syc-20353139
Some possible ways to prevent aortic valve stenosis are: […] Get a health checkup when you have a sore throat. Strep throat that is not treated can lead to rheumatic fever, which can damage heart valves. Strep throat can usually be easily treated with antibiotics. Rheumatic fever is more common in children and young adults. […] Keep the heart healthy. Talk about your risk factors for heart disease with your healthcare team. Ask how to prevent and manage them. Risk factors such as high blood pressure, obesity and high cholesterol may be linked to aortic valve stenosis. […] Take care of the teeth and gums. There may be a link between infected gums, called gingivitis, and a heart infection known as endocarditis. Endocarditis is a risk factor for aortic valve stenosis.
- #31 Preventionhttp://www.cardiosmart.org/topics/aortic-stenosis/prevention
There are steps you can take to strengthen your heart and guard against developing aortic stenosis. These include: […] Make heart-healthy choices: Although not proved, factors that can cause calcium buildup in the arteries of the heart (called atherosclerosis) also can cause calcium buildup on the aortic valve. […] Keep up with dental checkups: Infection in your gums can sometimes cause an infection of the heart valves and cause aortic stenosis. […] Treat infections: The bacteria that cause strep throat can sometimes cause rheumatic fever if left untreated. Rheumatic fever often happens in children and young adults and can be easily treated with antibiotics. If rheumatic fever is not treated, it can cause aortic stenosis years later.
- #32https://www.beaumont.org/services/heart-vascular/common-diseases-of-the-heart-valves
You can reduce your risk of heart valve disease by adopting a heart-healthy lifestyle that includes: […] Following your doctors recommendations related to heart health and disease prevention and treatment. […] short-term antibiotics prior to surgery or dental work to prevent infective endocarditis. […] long-term antibiotic therapy to help prevent strep throat if youve ever had rheumatic fever.
- #33 About Heart Valve Disease | Heart Disease | CDChttps://www.cdc.gov/heart-disease/about/heart-valve-disease.html
People may help to reduce their risk for heart valve disease by: […] Making heart-healthy choices by: […] Choosing heart-healthy foods, such as fresh fruits and vegetables. […] Following CDC physical activity guidelines for heart health. […] Managing stress. […] Getting to know your heart health by: […] Getting annual physical checkups, including having a health care professional listen to your heart with a stethoscope. […] Letting your health care team know if you have noticed changes in your heartbeat. […] Taking care of your overall health by: […] Having a good daily oral hygiene routine and getting regular dental checkups to reduce risk of heart infection. […] Getting treatment for respiratory infections such as strep throat. […] Taking antibiotics as instructed to prevent infection (such as when they are prescribed before surgery or dental procedures).
- #34 Heart Valve Disease Prevention | Vital Heart & Veinhttps://vitalheartandvein.com/news/heart-valve-disease-prevention/
Heart valve disease is more common in those over the age of 55. […] You can start by visiting your doctor and maintaining regular checkups. […] You should also cultivate a heart healthy lifestyle including regular physical activity and a balanced diet. […] There are some medicines aimed at preventing heart valve disease by improving blood flow, lowering cholesterol, and alleviating symptoms of heart disease. […] If you are interested in learning more about your own heart health, or heart valve disease prevention, take a look at both our physicians and procedures offered through our services at Vital Heart Vein. Through regular checkups, a nutritious diet, and consistent exercise, you can help do your best to keep your heart healthy.
- #35 Patient-centered Treatment for Heart Valve Disease.https://www.medstarhealth.org/blog/valvular-heart-disease
When it comes to keeping a healthy heart, most of us know what we should do: […] Talk with your primary care provider if you experience symptoms of heart valve disease. Your doctor, physician assistant, or nurse practitioner can help you navigate the care system, determine your next best steps, and provide you with verified information you can use to make good decisions.
- #36 Heart Valve Disease Patient Toolkit | Heart Disease | CDChttps://www.cdc.gov/heart-disease/php/data-research/heart-valve-disease-patient-toolkit.html
This handout includes steps people can take to help prevent heart valve disease. […] There are steps you can take to keep your heart healthy and prevent heart valve disease. For example, make sure that you: Eat heart-healthy foods, such as fresh fruits and vegetables. […] Early detection and treatment are key to managing your heart health. Take control of your heart by talking to your health care professional about #HeartValveDisease.
- #37 Calcific aortic valve disease: mechanisms, prevention and treatment – PubMedhttps://pubmed.ncbi.nlm.nih.gov/36829083/
Calcific aortic valve disease (CAVD) is the most common disorder affecting heart valves and is characterized by thickening, fibrosis and mineralization of the aortic valve leaflets. […] Age and congenital bicuspid aortic valve morphology are important and unalterable risk factors for CAVD, whereas additional risk is conferred by elevated blood pressure and plasma lipoprotein(a) levels and the presence of obesity and diabetes mellitus, which are modifiable factors. […] Although no medical therapy is effective for reducing or preventing the progression of CAVD, studies have started to identify actionable targets.
- #38 Heart Valve Disease Prevention | Vital Heart & Veinhttps://vitalheartandvein.com/news/heart-valve-disease-prevention/
Heart valve disease is more common in those over the age of 55. […] You can start by visiting your doctor and maintaining regular checkups. […] You should also cultivate a heart healthy lifestyle including regular physical activity and a balanced diet. […] There are some medicines aimed at preventing heart valve disease by improving blood flow, lowering cholesterol, and alleviating symptoms of heart disease. […] If you are interested in learning more about your own heart health, or heart valve disease prevention, take a look at both our physicians and procedures offered through our services at Vital Heart Vein. Through regular checkups, a nutritious diet, and consistent exercise, you can help do your best to keep your heart healthy.
- #39 Key to aortic valve disease prevention | Newsroom – McGill Universityhttps://www.mcgill.ca/newsroom/channels/news/key-aortic-valve-disease-prevention-239812
Lowering cholesterol early is a key to aortic valve disease prevention […] Our work provides confirmation that cholesterol is an important factor in the early stages of aortic valve disease and suggests that lowering cholesterol early in the disease process may provide protection from the development of aortic valve disease. […] Our next step calls for new randomized trials, maybe using one of several new LDL lowering agents, in the earliest stages of valve disease before we are able to confirm our hypothesis.
- #40 Key to aortic valve disease prevention: Lowering cholesterol early | ScienceDailyhttps://www.sciencedaily.com/releases/2014/10/141027120501.htm
Nowe dowody wskazujÄ , że choroba zastawki aortalnej może byÄ zapobiegana. […] Nasza praca potwierdza, że cholesterol jest ważnym czynnikiem we wczesnych stadiach choroby zastawki aortalnej i sugeruje, że obniżenie cholesterolu we wczesnym etapie procesu chorobowego może zapewniÄ ochronÄ przed rozwojem choroby zastawki aortalnej. […] Nasz nastÄpny krok wymaga nowych randomizowanych badaÅ, byÄ może z wykorzystaniem jednego z kilku nowych Årodków obniżajÄ cych LDL, we wczesnych stadiach choroby zastawki, zanim bÄdziemy mogli potwierdziÄ naszÄ hipotezÄ.
- #41 Aortic Stenosis Prevention: Is a New Cardiovascular Disease Paradigm Coming of Age?https://www.mdpi.com/2077-0383/14/3/903
In a multifactorial process the use of one single drug alone cannot be expected to be practically fully effective. This has been amply demonstrated in CVD. However, in real-life situations, most RCTs utilize one drug. […] RAAS inhibition is recommended as the main therapy in CAS patients with concomitant HTN. […] The combination of gastrointestinal bleeding and CAS is a well-described entity (Heydeâs syndrome). […] Studies have shown that post-menopausal estrogen treatments eliminate the risk of cardiovascular calcification when administered within the first five years of menopause; however, the timing, type, and dosing regimens of estrogen that confer such protection remains a very open field of investigation. […] In regards to current data, we believe that a hybrid strategy with some commonly used drugs in combination with lifestyle modification and mechanical or ultrasound de-calcifying interventions could retard CAS progression.
- #42 Aortic Valve Disease | Duke Healthhttps://www.dukehealth.org/treatments/heart/aortic-valve-disease
Aortic valve diseases, including aortic valve stenosis (a narrowed valve opening) and aortic valve regurgitation (a leaking valve), require evaluation and management by a cardiologist or cardiac surgeon. […] Medications may be prescribed to reduce and prevent aortic valve disease symptoms and complications. These may include ACE inhibitors or beta-blockers to lower blood pressure, antiarrhythmics to help maintain a regular heart rhythm, anticoagulants to prevent blood clots, and diuretics that can help reduce fluid retention. […] Our cardiac prevention and cardiac rehabilitation programs give you a personalized plan for recovery after surgery and help with long-term management of your heart health. Programs include exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.
- #43 Aortic Valve Disease | Duke Healthhttps://www.dukehealth.org/treatments/heart/aortic-valve-disease
Aortic valve diseases, including aortic valve stenosis (a narrowed valve opening) and aortic valve regurgitation (a leaking valve), require evaluation and management by a cardiologist or cardiac surgeon. […] Medications may be prescribed to reduce and prevent aortic valve disease symptoms and complications. These may include ACE inhibitors or beta-blockers to lower blood pressure, antiarrhythmics to help maintain a regular heart rhythm, anticoagulants to prevent blood clots, and diuretics that can help reduce fluid retention. […] Our cardiac prevention and cardiac rehabilitation programs give you a personalized plan for recovery after surgery and help with long-term management of your heart health. Programs include exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.
- #44 Aortic Valve Disease | Duke Healthhttps://www.dukehealth.org/treatments/heart/aortic-valve-disease
Aortic valve diseases, including aortic valve stenosis (a narrowed valve opening) and aortic valve regurgitation (a leaking valve), require evaluation and management by a cardiologist or cardiac surgeon. […] Medications may be prescribed to reduce and prevent aortic valve disease symptoms and complications. These may include ACE inhibitors or beta-blockers to lower blood pressure, antiarrhythmics to help maintain a regular heart rhythm, anticoagulants to prevent blood clots, and diuretics that can help reduce fluid retention. […] Our cardiac prevention and cardiac rehabilitation programs give you a personalized plan for recovery after surgery and help with long-term management of your heart health. Programs include exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.
- #45 Aortic Valve Disease | Duke Healthhttps://www.dukehealth.org/treatments/heart/aortic-valve-disease
Aortic valve diseases, including aortic valve stenosis (a narrowed valve opening) and aortic valve regurgitation (a leaking valve), require evaluation and management by a cardiologist or cardiac surgeon. […] Medications may be prescribed to reduce and prevent aortic valve disease symptoms and complications. These may include ACE inhibitors or beta-blockers to lower blood pressure, antiarrhythmics to help maintain a regular heart rhythm, anticoagulants to prevent blood clots, and diuretics that can help reduce fluid retention. […] Our cardiac prevention and cardiac rehabilitation programs give you a personalized plan for recovery after surgery and help with long-term management of your heart health. Programs include exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.
- #46 Aortic stenosis precautions and prophylaxis – wikidochttps://www.wikidoc.org/index.php/Aortic_stenosis_precautions_and_prophylaxis
Aortic stenosis of any etiology is associated with a higher rate of infection of the stenosed valve, i.e. infective endocarditis. The American Heart Association recommended that prophylaxis against infective endocarditis be limited only to patients with either prosthetic heart valves, previous episode(s) of endocarditis, or with certain types of congenital heart disease. Patients with severe aortic stenosis should avoid strenuous exercise and any exercise that greatly increases afterload such as weight lifting. […] To reduce the risk of developing infective endocarditis among high-risk patients, antibiotic prophylaxis should be considered prior to certain dental/medical/surgical procedures. Such procedures may include dental extraction, deep scaling of the teeth, gum surgery, dental implants, treatment of esophageal varices, dilation of esophageal strictures, gastrointestinal surgery where the intestinal mucosa will be disrupted, prostate surgery, urethral stricture dilation, and cystoscopy. […] Given the risk of myocardial ischemia and sudden cardiac death, patients with severe aortic stenosis ( 1.0 cm2) should avoid strenuous physical activity including weightlifting and other activities that increase afterload.
- #47 Aortic Valve Stenosis: Symptoms, Causes, Diagnosis, Treatmenthttps://www.webmd.com/heart-disease/aortic-valve-stenosis
Aortic Valve Stenosis Prevention […] You cant always stop aortic valve stenosis from happening. For instance, theres nothing you can do about a heart defect you were born with. But high blood pressure, high cholesterol, and obesity are linked to aortic valve stenosis, and those are issues you have some control over. Your doctor can advise you on ways to manage all of these conditions. […] Good dental hygiene also helps. Serious gum disease may be linked to heart inflammation. […] And if you ever have strep throat, be sure to treat it with a full round of antibiotics to prevent it from becoming rheumatic fever. If you get rheumatic fever, it can also be treated with antibiotics. […] The better you can manage some of these issues and the earlier you act on your symptoms, the lower are your chances of developing valve problems.
- #48 How to strengthen heart valves: Diet, exercise, and morehttps://www.medicalnewstoday.com/articles/how-to-strengthen-heart-valves-naturally
No treatment can reverse heart valve damage, but a person can slow the progression of aortic stenosis by managing other heart conditions and risks. […] A person can naturally maintain heart valve health by eating a heart-healthy diet, exercising regularly, not smoking, and managing blood pressure.
- #49 Aortic Stenosis Prevention: Is a New Cardiovascular Disease Paradigm Coming of Age?https://www.mdpi.com/2077-0383/14/3/903
Aortic valve replacement (AVR) still represents the only actual treatment for CAS improving survival and quality of life for patients symptomatic with severe CAS. […] Since the early 2000s, TAVR has been introduced and is steadily gaining ground. The lower morbidity and the shorter hospital stay associated with TAVR has prompted its application to younger patients and those with only moderate symptoms or asymptomatic CAS patients. […] A better understanding of the complex processes of CAS progression has shifted the field away from a purely degenerative disease model, with more emphasis on active valve mineralization, lipoprotein infiltration, active inflammation, and tissue remodeling. This has led to the identification of multiple possible therapeutic targets, beyond simple correlations between clinical parameters and disease progression.
- #50 Elevated blood pressure is linked to increased risk of aortic valve disease: analysis of 5.4 million adultshttps://www.escardio.org/The-ESC/Press-Office/Press-releases/elevated-blood-pressure-is-linked-to-increased-risk-of-aortic-valve-disease-ana
The study suggests that the associations are causal, but this requires further confirmation. […] Current European guidelines for the management of arterial hypertension do not consider AVDs as manifestations of heart damage related to hypertension and, consequently, do not suggest accurate assessment of aortic valve function and structure in patients with arterial hypertension. […] Thus, the findings provided by Rahimi et al might be considered the first step towards a change in the management of AVD and likely to influence future clinical trials and guidelines.