Mrsic Zorana, Hopkins Scott P, Antevil Jared L, Mullenix Philip S
Department of Medicine, Division of Cardiology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
Department of Surgery, Division of and Cardiothoracic Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA.
Prim Care. 2018 Mar;45(1):81-94. doi: 10.1016/j.pop.2017.10.002. Epub 2017 Dec 27.
This article outlines the diagnosis and management of commonly occurring valvular heart diseases for the primary care provider. Basic understanding of pathologic murmurs is important for appropriate referral. Echocardiography is the gold standard for diagnosis and severity grading. Patients with progressive valvular heart disease should be followed annually by cardiology and imaging should be performed based on the severity of valvular dysfunction. Surgery or intervention is recommended only when symptoms dictate or when changes in left ventricular function occur. Surgery or intervention should be performed after discussion by a heart team, including cardiologists and cardiac surgeons.
本文概述了基层医疗服务提供者对常见心脏瓣膜病的诊断和管理。对病理性杂音有基本的了解对于进行适当的转诊很重要。超声心动图是诊断和严重程度分级的金标准。患有进展性心脏瓣膜病的患者应由心脏病专家每年进行随访,并应根据瓣膜功能障碍的严重程度进行影像学检查。仅在出现症状或左心室功能发生变化时才建议进行手术或干预。手术或干预应在包括心脏病专家和心脏外科医生在内的心脏团队进行讨论后进行。