Valvular emergencies

Symptomatic:

1) Mitral Regurg

    -Rx: reduce afterload (e.g. nitroprusside, NTG)

    -If 2nd to AMI, Rx: NTG

2) Mitral Stenosis

    -Rx: rate control if tachy

    -Associated with hemoptysis

    -Transfuse + surg

3) Aortic Regurg

    -Rx: reduce afterload (e.g. nitroprusside, NTG)

4) Aortic Stenosis

    -Rx: rate control if tachy

    -Do not reduce afterload!! (use nitrates very cautiously)

    -Admit if symptomatic (e.g. syncope)

    - + A.fib = emergency, consider emergent cardioversion

• Consider emerg surg for all if primary cause of sx or refractory to Rx

See Also

Cards: Heart Murmur Sounds

Cards: Heart Murmur Manuvers

Source

10/07 DONALDSON (adapted from Tintinalli, emedicine)