The presence of persistent symptoms in patients with valvular heart disease determines the indications for admission to the hospital. Patients with acute onset of valvular incompetence are acutely ill and require admission. This should be clinically obvious. Patients with aortic stenosis presenting with syncope on exertion should be considered for admission because of the critical limitation of blood flow that syncope usually heralds. Patients with valvular heart disease and a new symptomatic dysrhythmia should also be considered for admission. Considerations for admission of patients with suspected infective endocarditis are discussed later in this chapter. Patients with intermittent symptoms from valvular heart disease can be management dilemmas. Consultation with a cardiologist may be required to determine the need for hospital admission.
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