Emergency Department Management and Admission Indications

The medical management of patients with valvular dysfunction is the same as that described under " Emergency.Department.Careo

Disease," above. The evaluation and management of endocarditis is described in the following section. Acute prosthetic valvular dysfunction due to thrombotic obstruction has been successfully treated with thrombolytic therapy, but the diagnosis requires angiography and therefore is not be done by an emergency physician without consultation with a cardiologist.

Patients suspected of having acute prosthetic valvular dysfunction or endocarditis require admission to the hospital and evaluation for possible valve replacement. Disposition of patients with worsening of symptoms can be problematic, and consultation with the patient's regular physician is needed.

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