Pre PACES Podcast #7 Prosthetic Heart Valves
Apr 25, 2021
Dr. Benoy Shah, a consultant cardiologist and President of the British Heart Valve Society, shares his expertise on prosthetic heart valves. He explains essential examination clues and how to present case findings effectively, focusing on mechanical vs. bioprosthetic valves. Benoy discusses complications and the importance of anticoagulation management, emphasizing that NOACs aren't suitable for mechanical valves. To lighten the mood, he tackles rapid-fire cricket questions, showcasing his passion beyond medicine!
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Prioritise Mechanical Valves In PACES
- Focus examination on mechanical prosthetic valves for PACES because bioprosthetic findings are usually too subtle to detect.
- Prioritise identifying metallic clicks, sternotomy scars, and anticoagulation signs during your inspection and palpation.
Use Scars To Infer Past Cardiac Surgery
- Inspect for a midline sternotomy and check the legs for vein-harvest scars to distinguish valve surgery from CABG.
- Also look for radial harvest scars and remember surgeons sometimes use internal mammary grafts instead.
Assess Decompensation As A Cluster
- Look for clusters of signs when assessing decompensation: JVP, lung bases, and peripheral oedema.
- Present these collectively to support whether a prosthetic valve is functioning normally or causing heart failure.