Clinical meaning
Stenotic valves create pressure overload upstream, causing concentric hypertrophy. Regurgitant valves cause volume overload, leading to eccentric dilation. Aortic stenosis produces a pressure gradient that reduces cardiac output and coronary perfusion, while mitral regurgitation causes pulmonary congestion from volume regurgitating into the left atrium.
Diagnosis & workup
Diagnostics & workup: - Order transthoracic echocardiogram for severity grading - Order transesophageal echocardiogram for surgical planning - Order exercise stress testing for asymptomatic severe disease - Order BNP to assess hemodynamic burden - Order cardiac catheterization if echo-clinical discordance - Order CT calcium scoring for aortic stenosis
Risk factors: - Rheumatic heart disease (mitral stenosis) - Bicuspid aortic valve (aortic stenosis) - Age-related calcific degeneration - Infective endocarditis - Myxomatous degeneration (mitral valve prolapse) - Marfan syndrome - Prior radiation therapy