Knowledge of valvular heart disease is important to an emergency physician in three main situations:

  • Emergency physicians may hear a murmur during auscultation of the heart and need to be able to decide whether the murmur is significant or not
  • Patients with known valve problems may present with signs and symptoms suggesting that they are beginning to decompensate and need onward referral to prevent significant morbidity and mortality
  • Emergency physicians managing an acutely unwell patient with serious haemodynamic compromise should be able to recognise when a heart valve problem is involved

Major valvular emergencies

The major valvular emergencies are:

  • Infective endocarditis
  • Papillary muscle rupture or flail mitral (posterior) leaflet due to ruptured chordae tendinae
  • Prosthetic valve thrombosis/dehiscence

This session deals with the important presentations of valve disease in adults.

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