Prosthetics
This is recommended for the rest of the patient's life if they have a prosthetic valve of any kind
Life long warfarin
Warfarin
- also LA thrombus, systemic embolization if have concurrent MS
This is the frequency range of echo evaluation for mild aortic stenosis (mean gradient < 20, 2.0-2.9 m/s)
Note: if within 1 year will of range will accept
Every 3-5 years
Diastolic, low-pitched, decrescendo
heard best left lateral decubitus position at cardiac apex
What is mitral stenosis
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Who is Drake?
Drake stans advised to leave
Annual echo evaluation is recommended in patients with a bioprosthesis starting how many years after receiving?
10 years
Treatment for severe MS with favorable valve morphology
Percutaneous balloon mitral commissurotomy
Echo evaluation frequency for moderate AS (3.0-3.9 m/s or gradient 20-39)
1-2 years
Diastolic, decrescendo
Left lower sternal border
May have P2 present
What is pulmonary regurgitation
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This is highly recommended in addition to warfarin in patients with mechanical prosthesis, and is considered reasonable for bioprosthesis
What is ASA
Risk of thromboembolism in A fib with MS
will take if within 5%
20-25%
Echo evaluation frequency for severe AS (mean gradient > 40 mmHg, Vmax > 4 m/s, AVA < 1.0 cm2)
q6-12 months
Systolic, crescendo-decresendo, LLSB
ddx: VSD is holosystolic but also LLSB
LLSB murmurs: Aortic regurgitation (if valvular, may also be RLSB), VSD, PR, TR.
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Goal INR for aortic valve prosthesis with VTE risk factors (ie A fib, embolization, hypercoaguability disorder, LV dysfunction) vs without risk factors
Risk- > 3.0
No risk > 2.5
Echo evaluation schedule for mild AR
q3-5 years
MCC of severe AS
AV degeneration
systolic, cresendo descrescendo, RUSB
ASD
RUSB ddx: AS, ASD, innocent flow murmur
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no sneak dissin'
ACC/AHA guidelines for ages to receive Bioprosthetic vs mechanical valve
Mechanical < 50
Bioprosthetic > 70
- 50-70 is Shared medical decision making
Echo evaluation schedule for both moderate-severe AR
q1-2 years
Intervention recommendation for trileaflet AS, intermediate-high surgical risk, without concomitant Severe AR
TAVR
-lots of requirements
Mid-systolic, crescendo-decrescendo, right upper sternal border with radiation to the right clavicle, carotid, or cardiac apex
What is aortic stenosis
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Who is Kendrick Lamar
- deduction of 1000 points for saying Drake or Aubrey