Prosthetic Heart Valves Differential Diagnoses

Updated: Feb 18, 2015
  • Author: Eric M Kardon, MD, FACEP; Chief Editor: Richard A Lange, MD, MBA  more...
  • Print
DDx

Diagnostic Considerations

Other conditions to consider in patients with prosthetic heart valves include the following:

  • Hemolytic anemia

  • Thromboembolic disease

  • Cardiac conduction disturbances

Prepare patients with acute primary valve failure and severe hemodynamic compromise for surgery as quickly as possible. Delays in surgery to pursue diagnostic testing result in increased mortality.

Consider PVE in any patient with a prosthetic valve and a fever.

Pregnancy

Some debate exists concerning the most advantageous method of providing adequate anticoagulation in pregnant patients with mechanical prostheses. [18]

Warfarin increases the chance of spontaneous abortion and stillbirths and is associated with teratogenicity from 6-12 weeks gestation.

Current recommendations are to use heparin from 6-12 weeks and from 38-40 weeks gestation. Warfarin may be used for the remainder of pregnancy.

The American College of Obstetrics and Gynecology has recommended against using low molecular weight heparin in pregnancy.

Differential Diagnoses