Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • hx of rheumatic fever
  • dyspnea
  • orthopnea
  • paroxysmal nocturnal dyspnea
  • hemoptysis
  • hoarseness
  • opening snap on auscultation
  • diastolic murmur
  • loud P2
  • neck vein distension
  • peripheral edema
  • ascites

Other diagnostic factors

  • 40 to 50 years old
  • loud S1
  • irregularly irregular pulse
  • flushed cheeks

Risk factors

  • streptococcal infection
  • female gender
  • ergot medications
  • serotogenic medications
  • SLE
  • amyloidosis
  • bronchial carcinoid syndrome

Diagnostic investigations

1st investigations to order

  • ECG
  • CXR
  • transthoracic echocardiography
Full details

Investigations to consider

  • transesophageal echocardiography
  • cardiac catheterization
  • dynamic exercise testing
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Blase Carabello

Professor of Medicine

Icahn School of Medicine

Chairman

Mount Sinai Beth Israel Department of Cardiology

New York

NY

Disclosures

BC declares that he has no competing interests.

Peer reviewers VIEW ALL

Associate Professor of Pediatrics

Medical Director

Pediatric Cardiothoracic Intensive Care Unit

University of Michigan Congenital Heart Center

C.S. Mott Children's Hospital

Ann Arbor

MI

Disclosures

JRC declares that he has no competing interests.

Professor of Medicine

VA Greater Los Angeles Healthcare System

UCLA School of Medicine

Los Angeles

CA

Disclosures

DL declares that he has no competing interests.

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