#83: Valvular heart disease, anticoagulation, TAVR, and primary care

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Get the latest on valvular heart disease: TAVR vs SAVR, choice of valve type, rheumatic heart disease, antibiotic prophylaxis for endocarditis, who needs an echocardiogram, and anticoagulation goals with tips from cardiologist, Dr Eli Gelfand, Section Chief of General Cardiology at Beth Israel Deaconess Medical Center in Boston and an Assistant Professor of Medicine at Harvard Medical School. Correspondent Dr Kate Grant joins us for this conversation w/Dr Gelfand about his common sense approach to the evaluation and management of valvular heart disease.

Written by Kate Grate, MD and Matthew Watto, MD.

Full show notes available at http://thecurbsiders.com/podcast

Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Time Stamps

  • 00:00 Disclaimer
  • 00:35 Intro
  • 02:55 Guest bio
  • 04:15 Getting to know our guest
  • 12:18 Picks of the week
  • 17:07 Clinical case of aortic stenosis
  • 18:00 Types of valve procedures available and initial workup for valvular disease
  • 26:11 Counseling patients about a heart murmur
  • 29:33 Symptoms in valvular heart disease
  • 31:07 Who needs an echo?
  • 32:36 Who needs a referral?
  • 34:40 Frequency of echocardiogram
  • 36:25 Medications for valvular heart disease
  • 39:12 Diuretics and aortic stenosis
  • 40:40 Medication for mitral stenosis and anticoagulants in valvular heart disease
  • 43:31 INR goals and use of ASA by valve type and position
  • 45:23 Endocarditis prophylaxis
  • 48:50 Rheumatic heart disease
  • 51:55 Valvulitis and a quick history lesson
  • 53:50 Transaortic valve replacement
  • 57:58 Multidisciplinary teams and how to determine if valve is causing symptoms
  • 62:14 Take home points
  • 63:47 Closing thoughts from The Curbsiders
  • 66:15 Outro

Tags: valve, heart, disease, valvular, cardiomyopathy, failure, systolic, murmur, aortic, mitral, tricuspid, surgery, tavr, diuretic, rheumatic, stenosis, regurgitation, echo, echocardiogram, repair, replacement, inr, anticoagulation, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

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