General practice Terapia 2020, 12 ( 395 ) : 98 - 104
The most common primary valve disease in medical practice: management of patients who have undergone valvular intervention caused by aortic stenosis
Summary:
All patients who have undergone a valve intervention require lifelong follow-up. Recent advances in the treatment of aortic stenosis achieved through collaboration between cardiologists and cardiac surgeons have been remarkable, resulting in a growing number of patients with a valve prosthesis. These patients need to have access to prophylaxis in order to prevent complications not only in cardiology outpatient clinics but also, and most obviously, in general practitioner clinics. General practitioners (GP) treat all common medical conditions and refer patients to specialists and other medical services for urgent and elective treatments/examinations. Not only do they focus on a holistic health approach related to a wide range of health conditions, but also combine it with psychological and social aspects of care. Such an attitude results in great responsibility for patients after a valve intervention. It is the GP who will manage the anticoagulant treatment on an everyday basis, and will be the first one to recognize early symptoms of deterioration in the valve prosthesis. There are a lot of potential complications which can occur following a valve intervention. Many of them can be recognized early by the GP. It is a vital and valuable function of the GP to notice symptoms of heart failure, valve thrombosis, thromboembolism, hemolysis and paravalvular leak, bioprosthetic valve failure and endocarditis. In case any new symptoms are spotted, non-valvular-related causes such as coronary artery disease, hypertension or sustained arrhythmias should also be considered. In most of these cases, patients should be referred to cardiologists for further diagnostics or, in urgent situations, should be sent to emergency departments. Cooperation between cardiologists, cardiac surgeons and general practitioners is valuable and still underrated in many regions.
Keywords: aortic stenosis, valve dysfunction, treatment
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