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    A Handbook of Multivalvular and Prosthetic Valve Disease
    A Handbook of Multivalvular and Prosthetic Valve Disease
    A Handbook of Multivalvular and Prosthetic Valve Disease
    Ebook124 pages51 minutes

    A Handbook of Multivalvular and Prosthetic Valve Disease

    By Alok Ranjan

    ()

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    About this ebook

    "A Handbook of Multivalvular and Prosthetic Valve Disease" contains a detailed description of the disease. There are no clear cut guidelines about management of multivalvular disease. However, author has tried to deal in simple and comprehensible manner. Special effort has been made to explain the clinical features (Symptoms and signs) of multivalvular disease and to decide about dominant lesion in each case. Likewise, the prosthetic valve evaluation has also been dealt in great details in this book. Readers will find it very useful as current books lack a detailed description of prosthetic valves. Prosthetic valve dysfunction, its assessment and management is again highlight of this handbook. The treatment section includes description about the various interventions (catheter based as well as surgical) and it also includes the ACC / AHA guidelines whereever possible.
    All in all, the book promises to be a great reference book for multivalvular and prosthetic Valve Disease and is worth having it on shelf for easy reading. Pointwise and concise writing has made this book specially useful for students and exam going students.
    LanguageEnglish
    PublisherAuthorHouse
    Release dateDec 18, 2012
    ISBN9781477292402
    A Handbook of Multivalvular and Prosthetic Valve Disease

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      Book preview

      A Handbook of Multivalvular and Prosthetic Valve Disease - Alok Ranjan

      © 2012 Alok Ranjan. All rights reserved.

      No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

      Published by AuthorHouse 12/17/2012

      ISBN: 978-1-4772-9240-2 (e)

      ISBN: 978-1-4772-9241-9 (hc)

      ISBN: 978-1-4772-9242-6 (sc)

      Library of Congress Control Number: 2012921817

      Any people depicted in stock imagery provided by Thinkstock are models,

      and such images are being used for illustrative purposes only.

      Certain stock imagery © Thinkstock.

      Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

      Contents

      Multivalvular Disease

      General concepts

      Etiology

      Mixed Single-Valve Disease

      Multivalvular lesions

      Tricuspid valve in combined valvular disease

      Pulmonary valve disease in combined valvular disease

      Prosthetic Valves

      Introduction

      Classification of Prosthetic Heart Valves

      Features of commonly used prosthetic valves

      Hemodynamics of prosthetic valves

      Selection of a prosthetic valve

      Radiological Appearance of Prosthetic valves

      Prosthetic valve dysfunction

      Complications of Prosthetic Valves

      Hemorrhagic complications of anticoagulation

      Prosthetic valve endocarditis (PVE)

      Hemolysis

      Structural Failure of Prosthetic Valves

      Prosthetic valve evaluation: Echocardiography

      Antithrombotic Therapy after prosthetic valve surgery

      Pregnancy and Prosthetic Valves

      Antibiotics Prophylaxis for Infective Endocarditis

      Suggested Reading

      Abbreviations

      Disclaimer

      Medicine is a constantly changing science. New research findings necessitate continual changes in disease concept and its management. The author and publisher of this handbook have used reasonable efforts to provide up-to-date, accurate information that is within generally accepted medical standards at the time of publication. However, as medical science is ever evolving, and human error is always possible, the author and publisher (or any other involved parties) do not guarantee total accuracy or comprehensiveness of the information in this handbook, and they are not responsible for omissions, errors, or the results of using this information. The reader should confirm the accuracy of the information in this handbook from other sources. In particular, all drug doses, indications, and contraindications should be confirmed in package inserts.

      The author has made every effort to trace the copyright holders for borrowed material. If he has inadvertently overlooked any, he will be pleased to make necessary arrangement at the first opportunity.

      Dedicated to my friends

      in Patna Medical College and Hospital

      When I go down the memory lane, I am overwhelmed with the memories of time that I have spent with my friends of Patna Medical College. Though I cannot include the names of all of them, a few deserve special mention since they have tolerated me the most; Ashutosh, Amar, Rajat, (Late) Ashish and (Late) Amitabh. I treasure the time spent with them.

      "It’s the times we’re so crazy,

      that people think we’re high.

      It’s the times we laugh so hard,

      we can’t help but cry.

      It’s all the inside jokes

      and remember whens.

      those are all the reasons

      that we’re best friends!"

      - Unknown

      Multivalvular Disease

      General concepts

      Steps in clinical decision making in patients with valvular heart disease. (Rahimtoola SH)

      1.   Perform a complete clinical evaluation

      History

      Physical Examination

      Routine blood investigations

      ECG

      Chest X-ray

      2.   Diagnosis and assess severity of disease

      All valves

      Ventricular Function

      Hemodynamic Effects

      Coronary Artery Disease

      Other Cardiovascular Disease

      Effects on other organs

      Other Organ Diseases

      3.   List questions that need answering

      4.   Perform test(s) most likely to provide these answers with the following criteria:

      Reliability

      Accuracy

      Lowest risk to patients

      Reasonable (or lowest) cost

      5. Review results of test(s) and make an overall assessment of patient

      6. Make recommendations regarding management

      Description of cardiac murmurs

      Description must include following points

      Timing, configuration or shape

      Character

      Length

      Site of best audibility

      Grade

      Selective conduction

      Relation to physiological act or maneuver

      Accompanying features

      Classification of Murmurs

      Category      Definition

      Systolic Murmur   Starts with or after S1 and ends before or at S2

      Ejection systolic   Starts after S1 and ends before S2 of that side (A2 or P2)

      Pansystolic   Starts with S1 and ends with S2 of that side (A2 or P2)

      Late systolic   Starts after S1 and ends S2 of that side (A2 or P2)

      Early systolic   Starts with S1 and does not reach S2

      *   In the auscultation of systolic murmurs, concentration on the last 1/3rd of systole is of great importance

      Diastolic murmurs   Stars with or after S2 and ends at or before S1

      Early Diastolic   Starts with S2 (A2 or P2), duration in diastole is variable

      Mid diastolic   Starts after S2 and ends before S1

      Late diastolic   Starts late after S2 and extends to the S1 of that side

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