2nd National Heart Valve Summit 2012
1. Symptomatic mitral and aortic valve disease needs surgery
2. Treadmill, available, physiologic, but imaging is only post stress, rapid HR change in post ex period
3. Supine bicycle is better, assess Doppler during exercise, but not as [physiologic
4. Drug stress, is in AS low output state, Dobutamine.
5. AS: severe symptomatic: no need.
6. AS: asymptomatic severe AS, TMT done to unmask abnormal BP response, if present indication for surgery.
7. AS low flow gradient, DSE is needed.
8. AR, symptomatic, NO exercise test.
9. AR, asymptomatic, severe AR, EX can unmask symptoms.
10. MSA: symptomatic no role.
11. Asymptomatic moderate MS no role of exercise tests.
12. Asymptomatic MS, severe mean gradient >10 mm Hg, VA < 1cm2, TMT has a role.
13. PAP > 60 after exercise is important.
14. MR asymptomatic role of exercise
15. Moderate MR, role for exercise
16. Prosthetic valve, increase in mean gradient after exercise > 20 mm in aortic and > 12 in mitral prosthesis is important.,
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