VALVULAR HEART-DISEASE - RECOMMENDATIONS FOR INVESTIGATION AND MANAGEMENT

Despite the decline of rheumatic fever, valvular heart disease remains a common and important problem. The investigation and treatment of pa tients have been revolutionised by the widespread availability of echo cardiography, which provides information about disease aetiology, accu rate and non-invasive assessment of severity and a means of monitoring progression. These advances have facilitated progress in reconstructi ve valve surgery and the application of balloon valvuloplasty. Improve d valve prostheses and reduction in peri-operative mortality have also broadened the indications for valve replacement surgery. A working pa rty convened by the British Cardiac Society and the Royal College of P hysicians of London have reviewed current practice and provided guidel ines, summarised in this article, for the investigation and management of adults with valvular heart disease in primary care, district gener al hospitals and tertiary referral centres.