41. BHF Heart Health - Heart Conditions: Valvular Heart Disease And Pregnancy The British Heart Foundation (BHF) is the leading national charity fighting heart and circulatory disease the UK s biggest killer. The BHF funds research, http://www.bhf.org.uk/hearthealth/index.asp?secID=1&secondlevel=77&thirdlevel=47

42. CNN - Valvular Heart Disease Associated With Fenfluramine-phentermine - June 8, valvular heart disease was identified in 24 women treated with We report 24 cases of unusual valvular heart disease in patients receiving treatment with http://www.cnn.com/HEALTH/9707/08/fenphen.report/

Valvular heart disease associated with fenfluramine-phentermine July 8, 1997 Web posted at: 2:58 p.m. EDT (1858 GMT) Heidi M. Connolly, M.D. Jack L. Crary, M.D. Michael D. McGoon, M.D. Donald D. Hensrud, M.D., M.P.H. Brooks S. Edwards, M.D. William D. Edwards, M.D. Hartzell V. Schaff, M.D. From the Divisions of Cardiovascular Diseases and Internal Medicine (H.M.C., M.D.M., B.S.E.), Preventive and Occupational Medicine, Endocrinology and Internal Medicine (D.D.H.), Anatomic Pathology (W.D.E.), Thoracic and Cardiovascular Surgery (H.V.S.), Mayo Clinic and Mayo Foundation, Rochester, Minnesota, and the MeritCare Medical Center, Heart Services, Fargo, North Dakota (J.L.C.). Address reprint requests to Dr. Connolly at Mayo Clinic, 200 First Street SW, Rochester, MN 55905 NOTE: This is the manuscript of the study that has been submitted to The New England Journal of Medicine. The published version of the report may differ. ABSTRACT Background Fenfluramine and phentermine are anorectic agents individually approved by the United States Food and Drug Administration. The drugs used in combination may yield equivalent efficacy in weight reductions at lower doses of each agent and with fewer reported side effects. In 1996, the total number of prescriptions in the United States for fenfluramine and phentermine exceeded 18 million. Methods Valvular heart disease was identified in 24 women treated with fenfluramine-phentermine who had no previous history of cardiac disease. Patients presented with symptoms or a murmur. A perceived association between the clinical features and the fenfluramine-phentermine therapy evolved by communication among authors.

43. Congenital And Valvular Heart Disease And How They Effect Identifies risks for the diver with intracardiac defects and valvular heart problems. http://www.scuba-doc.com/cngvlvhd.htm

HOME Heart Valvular and Congenital Heart Disease Search This Site Web scuba-doc.com Valvular and Congenital Heart Disease Patients that have valvular or some form of congenital heart disease have an excess strain situation that is particularly susceptible to the effects of increased exercise and blood shifting intoo the heart and lungs due to water immersion. The presence of an abnormality per se is not a contraindication to diving. In the case of intracardiac shunts due to holes in the walls, and in the presence of significant valve narrowing or widening inside the heart, diving is contraindicated. Pathophysiological Principles In considering the pathophysiology of congenital and valvular heart disease one should be aware of the effect of the lesions on the heart muscle. Overload lesions of the heart can be classed as either pressure or volume overload types. Pressure overload lesions include the enlargement of the left ventricle of the heart that results from blockage of the blood due to narrowing of the aortic valve (aortic stenosis), whereas volume overload of the left side of the heart (ventricle) can occur from leaking aortic and mitral valves (aortic or mitral regurgitation) or in the right side of the heart from a hole between the upper chambers (atria) or atrial septal defect. The response of the heart muscle to these overload states depends on whether the overload is a pressure or volume type. The myocardium appears to adapt specifically to handle the type of load imposed.

44. Antithrombotic Therapy In Valvular Heart Disease -- Native And Prosthetic: The S Antithrombotic therapy in valvular heart disease native and prosthetic the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=5895

45. Antithrombotic Therapy In Valvular Heart Disease -- Native And Prosthetic: The S Patients with valvular heart disease receiving oral anticoagulant (OAC) therapy Longterm Anticoagulant Therapy in a Patient with valvular heart disease http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=5895&nbr=3881

46. Valvular Heart Disease - Book Information Drug induced valvular heart disease, 19. Prosthetic heart valves, 20. Pregnancy and valvular heart disease, 21. valvular heart disease in the elderly, 22. http://www.blackwellpublishing.com/book.asp?ref=1840760583

47. Surveys Programme - Valvular Heart Disease In the Euro Heart Survey for valvular heart disease the following issues are addressed Current anticoagulation practice in valvular heart disease http://www.escardio.org/knowledge/ehs/survey/Valvular_Heart_Disease.htm

Home About Us Contact Us Site Map Search for Home Knowledge Centre Surveys Programme Euro Heart Survey Publications ... Working Groups Surveys Programme Status: Survey over (results published) Topic: Valvular Heart Diseases Valvular Heart Disease Alec Vahanian Paris, France Chairman The purpose of this survey is to collect data from a selected sample of cardiology departments throughout Europe, to evaluate the current practice in evaluation and treatment of valvular heart disease, and the accordance between existing guidelines and current practice. Issues In the Euro Heart Survey for Valvular Heart Disease the following issues are addressed: 1. Use of diagnostic procedures Catheterisation in pre-operative evaluation Echocardiography (Mode: transthoracic or transoesophageal approach, Frequency, Indications) Exercise testing 2. Intervention during active endocarditis Indications for surgery (heart failure, infection, or other) Duration of antibiotic treatment before surgery Type of surgery 3. Management of patients after prosthetic valve replacement

48. Valvular Heart Disease (WG 14) - Nucleus & Membership Euro Heart Survey. valvular heart disease (WG 14). Print version. Nucleus. Chairman. Prof. RJC Hall FESC, Health Policy and Practice University of East http://www.escardio.org/bodies/WG/wg14/

Home About Us Contact Us Site Map Search for Home ESC Constituent Bodies ESC Working Groups Valvular Heart Disease (WG 14) ... Euro Heart Survey Valvular Heart Disease (WG 14) Nucleus Chairman Prof. R.J.C. Hall FESC , Health Policy and Practice University of East Anglia, School of Medicine, Norwick NR4 7TJ , (UK) Tel: +44 (1603) 593 606, Fax: +44 (1603) 259 401, e-mail Vice - Chairman Prof. M. de Jesus Antunes FESC , Cardiothoracic Surgery, University Hospital, Praceta Mota Pinta, 3000 Coimbra, (PT) Tel: +351 (239) 400 418, Fax: +351 (239) 829 674, e-mail Past-Chairman Dr. C. Gohlke-B¤rwolf FESC , Ober¤sztin, Herzzentrum, S¼dring 15, 79189 Bad Krozingen, (DE), Tel: +49(7633) 402 546, Fax: +49(7633) 402 212, e-mail Treasurer Dr. P. Tornos Mas , Servicio de Cardiologia, Hospital Vall d'Hebron, Paseo Vall d'Hebron 119-129, ES-08035 Barcelona, (SP), Tel: +34 (93) 274 6070, Fax: +34 (93) 274 6063, e-mail Dr. B. Iung , Service de Cardiologie A, Groupe Hospitalier Bichat-Claude Bernard, 46 rue Henri Huchard, Cedex 18, FR-75877 Paris, (FR)

49. Valvular Heart Disease - New Treatments, January 22, 2005 Advances in the Evaluation and Treatment of valvular heart disease, January 22, 2005. http://www.medical-library.org/journals2a/valvular_heart_disease.htm

Click here to view next page of this article Valvular heart disease Rheumatic heart disease is the leading cause of mitral stenosis in developed countries. Its incidence has declined sharply wherever standards of living have improved and where penicillin is routinely used during episodes of pharyngitis due to group A streptococcus. Occasional small epidemics still occur in the US. The major manifestations of VHD include both valvular heart disease, murmurs, aortic stenosis, mitral stenosis, mitral regurgitation, mitral prolapse, mitral valve prolapse left and right heart failure, left and right ventricular hypertrophy, atrial and ventricular arrhythmias, syncope, angina. pulmonary and systemic emboli, and endocarditis. With the exception of infectious etiologies, there are no known medical therapies that arrest the natural progression of the primary valvular stenotic or regurgitant lesions, and severe lesions ultimately require surgical therapy. Afterload reduction for chronic valvular heart disease, murmurs, aortic stenosis, mitral stenosis, mitral regurgitation, mitral prolapse, mitral valve prolapse aortic regurgitation can postpone the need for surgery, without compromising long-term outcome. Recognition of VHD Many patients with milder forms of VHD will be asymptomatic, with only a click or a murmur evident on exam. Most healthy adults do not have "benign" flow murmurs (except during pregnancy and certain systemic illnesses), and a murmur therefore usually represents some degree of valvular pathology. Correct identification of the origin of murmurs is essential, since quality of life and life span are limited in most severe forms of VHD. Murmurs due to organic VHD must be distinguished from functional murmurs caused by LV or RV dilation, hypertrophic cardiomyopathy, ischemic heart disease, or from murmurs due to intracardiac shunts and aortic coarctation. Congenital and myxomatous VHD must be identified because of the important risk of endocarditis.

50. Dx/Rx: Valvular Heart Disease Dx/Rx valvular heart disease Dennis A. Tighe, MD, University of Massachusetts Medical School, Theo E. Meyer, MD, University of Massachusetts Medical School http://medicine.jbpub.com/catalog/0763723851/

Cart Help Sign up for eUpdates Tell a Friend ... Medicine Product Details Key Features Table of Contents About the Author(s) Additional Resources Quick Links Find Your Sales Rep Technical Support International Sales Related Products Human Disease Medicine Clinical Research Cardiac Medicine Other Titles by these Authors Titles by Dennis A. Tighe Dx/Rx: Heart Failure Product Detail Add to Shopping Cart Recommend this title to your Library Dx/Rx: Valvular Heart Disease Dennis A. Tighe, MD, University of Massachusetts Medical School, Theo E. Meyer, MD, University of Massachusetts Medical School, Gerard P. Aurigemma, MD, FACC, University of Massachusetts Medical School ISBN: Price: (Sugg. US List) Cover: Paperback Pages: Tightly organized into a super-condensed outline bulleted format, this handy, pocket-sized manual details precise, up-to-date information for diagnosis and treatment of Valvular Heart Disease. Throughout the book, tables and figures summarize important clinical data and current professional society recommendations, while salient references direct readers to additional information. Current, quick, and concise, for instant access on the ward or in the clinic!

51. Valvular Heart Disease valvular heart disease Diseases of the heart’s valves deserve much attention. valvular heart disease is treated with medicine and when necessary, http://heart.uchc.edu/patientcare/services/valvular_heart.html

Home Patient Care Valvular Heart Disease Detecting Heart Disease ... On-line Resources Valvular Heart Disease Diseases of the heart’s valves deserve much attention. This is particularly the case in age-related narrowing of the aortic valve. This condition is now a frequent cause of atherosclerosis in adults and the most frequent reason for aortic valve replacement in patients with aortic valve narrowing. At the UConn Health Center, cardiologists and specialists provide expert care to diagnose and treat this condition. Valvular heart disease is treated with medicine and when necessary, heart surgeons will repair or replace the narrowed or leaky valves. UConn Health Center physicians who treat patients with valvular disease include: Division of Cardiology Chair Bruce Liang, M.D. Cardiologists Michael Azrin, M.D. W. David Hager, M.D. Peter Schulman, M.D. David Silverman, M.D. Cardiothoracic Surgeons Jonathan Hammond, M.D. Paul Preissler, M.D. David Underhill, M.D. Home ... Site Index

52. Valvular Heart Diseases :: The Doctors Lounge(TM) valvular heart diseases Moderator Yasser Mokhtar, MD The Doctors Lounge Forum Index valvular heart diseases Mark all topics read http://www.thedoctorslounge.net/cardiology/forums/viewforum.php?f=7

53. Valvular Heart Disease A person with valvular heart disease may have either insufficient or stenotic Symptoms for valvular heart disease can include shortness of breath and http://www.health-alliance.com/learnabout/learn_valvular.htm

search Behavioral Alcoholism Anxiety Bipolar Disorder Depression ... Panic Disorders Brain Tumors Acoustic Neuroma Glioblastoma Meningioma Pituitary Tumors Cancer Breast Lung Prostate Skin Epilepsy Generalized Complex Psychogenic Heart Aortic Aneurysms Angina Arrhythmias Atherosclerosis ... Valvular Disease Integrative Medicine Acupuncture Chiropractic Care Energy Healing Massage ... Yoga Therapy Stroke Aneurysms Arteriovenous TIA General Illnesses Abdominal Pain Allergies Asthma Bronchitis ... Upper Respiratory Your heart has four valves that work like gates, separating the heart chambers and controlling blood flow into and out of the heart. Normal heart valves open wide and close tight in response to changing pressure within the heart chambers. When there is valvular disease, the valves may not close tightly and blood may leak through. This is called insufficiency or regurgitation. When the valve does not open fully, it is described as stenotic. A person with valvular heart disease may have either insufficient or stenotic heart valves, or a combination of both. When heart valves do not function normally because of disease, your doctor may recommend replacement with a prosthetic (artificial) valve.

54. Phen/Fen & Valvular Heart Disease PHEN/FEN AND valvular heart disease July 8, 1997 QUESTIONS AND ANSWERS IS valvular heart disease RELATED TO PRIMARY PULMONARY HYPERTENSION? http://www.fda.gov/cder/news/phen/phenfenqa.htm

"PHEN/FEN" AND VALVULAR HEART DISEASE July 8, 1997 QUESTIONS AND ANSWERS 1. WHAT IS "PHEN/FEN" ? Phentermine ("phen") and fenfluramine ("fen") are prescription medications approved by the FDA as single medicines for short-term (a few weeks) use as appetite suppressants in the management of obesity. Some physicians have prescribed them recently to be used in combination with each other and to be used for extended periods of time in weight loss programs. Such use of the products is called "off label" because there have been no studies presented to the FDA to demonstrate either the effectiveness or safety of the two drugs taken together or for longer periods of time (greater than a few weeks). "Phen" is short for phentermine , an amphetamine-like drug marketed under various trade names such as Ionamin ® and Fastin® , as well as several generic forms of phentermine. It is approved for short-term use as an appetite suppressant. "Fen" is short for

55. Valvular Heart Disease Referral Guidelines valvular heart disease Referral Guideline. Diagnosis/Definition. valvular heart disease can be congenital or acquired leading to valvular stenosis and/or http://www.mamc.amedd.army.mil/referral/guidelines/cardio_valvular.htm

Angina Pectoris Atrial Fibrillation Congestive Heart Failure Murmurs (Adult) ... Transient Impairment of Consciousness Valvular Heart Disease Ventricular Arrhythmias MAMC Intranet or WRMC Internet Referral Guidelines Guideline Updated: 24 February 2004 Specialty: Cardiology Valvular Heart Disease Referral Guideline Diagnosis/Definition Valvular heart disease can be congenital or acquired leading to valvular stenosis and/or regurgitation with an accompanying murmur. Not all murmurs are associated with valvular disease. To evaluate a murmur of unclear origin, please see the separate referral guideline. Initial Diagnosis and Management History focused on symptoms of cardiac dysfunction (exercise tolerance, chest pain, dizziness, syncope, orthopnea), physical exam characterizing the murmur (timing, intensity, location, etc.) and looking for signs of dysfunction (rales, S3, S4, edema, jugular venous distention). PA and LAT CXR.

56. Nature Clinical Practice Cardiovascular Medicine | Is Pulmonary Vein Antrum Isol Patients had lone AF or one or more of valvular heart disease, Of 391 patients studied, 194 had lone AF, 102 had valvular heart disease, http://www.nature.com/ncpcardio/journal/v1/n1/full/ncpcardio0019.html

@import "/common/style/layout.css";/* do not edit this stylesheet */ @import "/common/style/main.css";/* do not edit this stylesheet */ @import "/clinicalpractice/style/layout_group.css";/* do not edit this stylesheet */ @import "/clinicalpractice/style/group.css";/* do not edit this stylesheet */ @import "/ncpcardio/style/site.css";/* edit this stylesheet only */ Accessibility statement Jump to main content Jump to main navigation Jump to search ... ABOUT NPG E-MAIL: PASSWORD Save password Forgotten password? MY ACCOUNT E-ALERTS SUBSCRIBE ... REGISTER Text to search for Advanced search Home Archive Vol 1 No 1 ... Practice Point Extract Practice Point Nature Clinical Practice Cardiovascular Medicine doi Is pulmonary vein antrum isolation safe and effective in valvular heart disease and open heart surgery? Hugh Calkins Correspondence The Johns Hopkins Hospital, 600 North Wolfe Street, Carnegie 592, Baltimore, MD 21287, USA Email hcalkins@jhmi.edu This article has no abstract so we have provided the first paragraph of the full text. The approach used for catheter ablation of AF has evolved considerably since Jais et al identified the PV as an important trigger of AF. Focal ablation targeting arrhythmogenic triggers within the PVs has been replaced by more anatomically based approaches.

57. Entrez PubMed METHODS We identified valvular heart disease in 24 women treated with fenfluraminephentermine who had no history of cardiac disease. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9

58. Entrez PubMed Antithrombotic therapy in valvular heart diseasenative and prosthetic the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1

59. BioMed Central | Full Text | Appetite Suppressants And Valvular Heart Disease &# Only one case of valvular heart disease was detected in 57 randomized controlled The risk of valvular heart disease is significantly increased by the http://www.biomedcentral.com/1472-6904/2/6

home journals A-Z subject areas advanced search ... Volume 2 Viewing options Abstract Full text PDF Associated material: Pre-publication history PubMed record Related literature: Articles citing this article on BioMed Central on Google Scholar Other articles by authors ... Similar articles (PubMed) Tools: E-mail to a friend Download references Post a comment Key E-mail Corresponding author Research article Yoon K Loke Sheena Derry and Angharad Pritchard-Copley Department of Clinical Pharmacology, University of Oxford, Radcliffe Infirmary, Oxford OX2 6HE, United Kingdom BMC Clinical Pharmacology The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6904/2/6 Received Accepted Published Outline Abstract Abstract Background Methods Results ... Pre-publication history Background Although appetite suppressants have been implicated in the development of valvular heart disease, the exact level of risk is still uncertain. Initial studies suggested that as many as 1 in 3 exposed patients were affected, but subsequent research has yielded substantially different figures. Our objective was to systematically assess the risk of valvular heart disease with appetite suppressants. Methods We accepted studies involving obese patients treated with any of the following appetite suppressants: fenfluramine, dexfenfluramine, and phentermine. Three types of studies were reviewed: controlled and uncontrolled observational studies, and randomized controlled trials. Outcomes of interest were echocardiographically detectable aortic regurgitation of mild or greater severity, or mitral regurgitation of moderate or greater severity.

60. BioMed Central | Full Text | Risk Of Valvular Heart Disease Associated With Use Weissman NJ Appetite suppressants and valvular heart disease. Schiller NB Fen/phen and valvular heart disease if it sounds too bad to be true, http://www.biomedcentral.com/1471-2261/3/5

home journals A-Z subject areas advanced search ... Volume 3 Viewing options Abstract Full text PDF Associated material: Pre-publication history PubMed record Related literature: Articles citing this article on Google Scholar Other articles by authors Hopkins PN ... Similar articles (PubMed) Tools: E-mail to a friend Download references Post a comment Key E-mail Corresponding author Research article Risk of valvular heart disease associated with use of fenfluramine Paul N Hopkins and Gerald I Polukoff Cardiology Division, University of Utah School of Medicine, Salt Lake City, USA BMC Cardiovascular Disorders The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2261/3/5 Received Accepted Published Keywords: fenfluramine, dexfenfluramine, aortic regurgitation, mitral regurgitation, risk Outline Abstract Abstract Background Methods Results ... Pre-publication history Background Estimates of excess risk of valvular heart disease among prior users of fenfluramine and dexfenfluramine have varied widely. Two major forms of bias appear to contribute to this variability and also result in a systematic under-estimation of risk. The first, a form of nondifferential misclassification, is the result of including background, prevalent cases among both exposed and unexposed persons in calculations of risk. The second bias results from not considering the relatively short duration of exposure to drugs. Methods We examined data from all available echocardiographic studies reporting the prevalence of aortic regurgitation (AR) and mitral regurgitation (MR) among persons exposed to fenfluramine or dexfenfluramine and a suitable control group. We also included one study in which previously existing AR or MR had been excluded. We corrected for background prevalent cases, estimated incidence rates in unexposed persons, and performed a person-years analysis of apparent incidence rates based on exposure time to provide an unbiased estimate of relative risk.

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