A structural dysfunction of a prosthetic heart valve is a rare but serious condition that can be life threatening. Rapid diagnosis is essential so that immediate cardiac surgery can be performed to replace the valve.
Presentation:
(1) history of a prosthetic heart valve replacement
(2) sudden onset of one or more of the following:
(2a) shortness of breath from pulmonary edema
(2b) chest pain
(2c) hypotension
Clinical auscultatory findings in prosthetic valve dysfunction:
(1) absence of clicks
(2) onset of a new murmur
(3) characteristic murmur for specific valve
(3a) aortic: diastolic murmur (? also for pulmonic)
(3b) mitral: holosystolic murmur (? also for tricuspid)
Additional workup:
(1) Try to find more about the prosthetic valve. The patient may carry a card in the wallet with this information, or it may be available in the medical record.
(2) Radiographic evidence of an abnormal valve position or defective parts.
(3) Echocardiography may be able to demonstrate the valvular dysfunction.
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