An approach to the diagnosis and management of valvular heart disease

Abstract

Corresponding author: B J Cupido (bj.cupido@uct.ac.za) Valvular heart disease poses a common yet difficult problem in everyday clinical practice. A thorough clinical evaluation with basic common investigations such as an electrocardiogram (ECG) and a chest radiograph (CXR) remains the cornerstone of diagnosis. Echocardiography and more invasive testing, if needed, are usually performed at specialist level to confirm the diagnosis, assess severity and assist in definitive decisionmaking.The causes and clinical, ECG and CXR features of the common valve lesions are described. Patients with symptomatic valve lesions should be referred for specialist assessment. In most cases, medical therapy serves as a bridge to definitive mechanical or surgical therapy.

Topic reviews need to be robust

“…Perindopril 4 mg as a single drug had no benefit on reducing stroke, [5] and perindopril 8 mg was needed to reduce events in high-risk cardiovascular patients. [6] The effective dose in heart failure is unknown. Telmisartan is also included in this review.…”

“…As such, in this successful collaboration, the CME articles were jointly produced by SA cardiologists and family physicians with the dual objectives of empowering doctors who manage these conditions in primary care settings in SA and improving the care of CVD patients in such settings. In the first issue, HF, [1] dyspnoea, [4] hypertension in the young [5] and valvular heart disease [6] were reviewed. In the second issue, infective endocarditis [7] and pericardial disease [8] were discussed.…”

Cardiovascular medicine in primary healthcare in sub-Saharan Africa: Minimum standards for practice (part 3)

“…It forms the third part of a series of articles jointly produced by South African (SA) cardiologists and family physicians with the dual objectives of empowering doctors who manage these conditions in primary care settings in SA and improving the care of CVD patients in such settings and emergency departments. In the first issue, heart failure, [7] dyspnoea, [8] hypertension in the young [9] and valvular heart disease [10] were reviewed. In the second issue, the important clinical problems of infective endocarditis [11] and pericardial disease [12] were discussed.…”

Cardiovascular medicine in primary healthcare in sub-Saharan Africa: Minimum standards for practice (part 1)

“…Cupido et al [9] review the diagnosis and management of valvular heart disease (VHD), a common but difficult problem in everyday clinical practice. Rheumatic heart disease, a sequela of streptococcal throat infection, remains a common cause of VHD in SA, and often has devastating complications in the young.…”