From the ESC and some other places:
- Peripartum cardiomyopathy needs heparin (prophylactic dose if ejection faction > 30%, treatment dose if less than 30% or if AF or previous clot).
- Pencillin V is continued for 10 years since the last episode of rheumatic fever, or until 40, whichever is longer.
- In severe AS (valve < 1cm^2, gradient > 40mmHg), surgery is indicated if symptomatic or if LVEF < 50% with no other cause.
- In MR, symptoms, LVEF <60% or new AF are all indications for surgery, which should be valve repair ideally. Andsuper acute MR is all about the diuretics and nitroprusside to get that afterload down.
- For MS with an area <1.5, it’s all about percutaneous mitral commissurotomy if there are symptoms or a high risk of thromboembolism.
- Pregnant lady needs a valve replaced? “In women who wish to become pregnant, the high risk of thromboembolic complications with a mechanical prosthesis during pregnancy—whatever the anticoagulant regimen used—and the low risk of elective reoperation are incentives to consider a bioprosthesis, despite the rapid occurrence of SVD in this age group.”