Valvular heart disease

Abstract

Valvular heart disease (VHD), although not as common as coronarydisease or hypertension, is an important, and challenging, clinicalentity. The prevalence of VHD is still high, increasing with age, affecting 13.2% of people over the age of 75. There have beenimportant changes in the distribution of the aetiologies of VHDin Western countries over the last 50 years and the degenerativeaetiology is now the most frequent. Increased age is associated witha higher frequency of comorbidity, rendering decision-making forintervention more complex. The presence of VHD is of interest in patients with heart failure(HF) because the treatment of the causative VHD may cureHF, which stresses the importance of its detection and appropriatetreatment. However, decision-making for surgery may be difficult in patients with VHD and HF because of higher operativemortality and concerns over late results, which may be worsenedby progression of the underlying disease. The present chapter will concentrate on adult patients eitherwith acquired VHD or with a valve prosthesis, focusing specificallyon the patient with HF.