Cardiology
Structural heart disease
Structural heart diseases include conditions affecting the heart's valves, walls, and chambers. These disorders can be congenital or acquired and often require intervention in acute and chronic settings. In the ICU, valvular emergencies, cardiomyopathies, and congenital heart defects may present as hemodynamic instability, requiring rapid assessment and treatment.
This section provides:
- Guidance on valvular heart disease management, including risk stratification, pharmacologic therapy, and surgical interventions.
- Pre-operative considerations, such as risk scores and criteria for transcatheter or surgical interventions.
- Post-operative care, including monitoring for complications like heart failure, arrhythmias, or valve dysfunction.
- Key interventional strategies, such as valve repair, TAVI/TAVR, and open-heart surgery.
With early recognition and tailored management, ICU professionals can optimize patient outcomes and prevent complications in critically ill patients with structural heart diseases.
Valvular heart disease
Valvular heart disease
2021 ESC/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)
Alec Vahanian et al., European Heart Journal (2022)
What’s inside
This article presents the 2021 ESC/EACTS guidelines for the management of valvular heart disease, providing evidence-based recommendations for diagnosis, treatment, and surgery. Take a start at Chapter 3.2 and read up to the end of the chapter for a general introduction, but note that it focuses more on outpatient diagnostics. Special attention is advised for part 3.3.1, which covers risk scores—very relevant for the pre-operative period. Chapters 4-10 should be read completely, albeit superficially.
Why it’s relevant
Valvular heart disease often requires timely and precise management, especially in the ICU, where patients may face acute complications. These guidelines offer key insights for pre-operative assessment, intervention, and long-term management of valvular heart conditions.
Key focus
- Diagnosis and assessment of valvular heart disease
- Risk scores and their role in pre-operative evaluation (Chapter 3.3.1)
- Pharmacologic management and surgical options
- Interventional strategies, including valve repair and replacement
- Post-operative care and monitoring
Takeaway
These guidelines are crucial for ICU professionals involved in the management of valvular heart disease. Focus on risk assessment and decision-making during the pre-operative period, and familiarize yourself with treatment and monitoring strategies for patients undergoing surgery or intervention.