Causes of Acute Presentation in Valve Disease

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Table 51.2

Causes of Acute Presentation in Valve Disease

Acute regurgitation

Endocarditis
Deceleration injury
Ruptured mitral chord (with mitral prolapse)
Papillary muscle rupture (acute mitral regurgitation)
Aortic dissection (acute aortic regurgitation)

Acute decompensation of previously stable native or prosthetic valve disease

Valve-related

Endocarditis
Progression of native disease
Prosthetic valve dysfunction
- Dehiscence
- Thrombosis
- Structural degeneration (i.e. valve failure)

Non-valvar

Decompensation of long-standing LV dysfunction
Acute myocardial infarction or myocardial ischaemia
Arrhythmia
Fluid-load
- Poor compliance with diuretic therapy
- Drugs causing fluid retention (e.g. NSAIDs, steroids)
- Iatrogenic fluid overload
Intercurrent illness (e.g. pneumonia, anaemia)