Esforço para válvulas

Class IIa
• 1.Exercise testing is reasonable in selected patients with asymptomatic severe Valvular Heart Disease (VHD) to 1) confirm the absence of symptoms, or 2) assess the hemodynamic response to exercise, or 3) determine prognosis(44–48). (Level of Evidence: B)

In a subset of patients, exercise stress testing will be of additional value in determining optimal therapy. Because of the slow, insidious rate of progression of many valve lesions, patients may deny symptoms as they gradually limit their activity level over years to match the gradual limitation imposed by the valve lesion. In patients with an equivocal history of symptoms, exercise testing helps identify those who are truly symptomatic. There may be patients in whom resting hemodynamics do not correlate with symptoms. In these patients, exercise hemodynamics may be helpful in determining the etiology of the symptoms, specifically in patients with mitral VHD. Exercise stress testing is of prognostic value in patients with asymptomatic severe aortic stenosis (AS) and provides further information about timing of intervention. Exercise testing in patients with severe VHD should always be performed by trained operators with continuous monitoring of the ECG and blood pressure (BP).

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A bicicleta é indispensável no ecoestresse de valvopatias.

É fundamental acompanhar o exames em todas as fases do exercício e interromper o esforço assim que a resposta for obtida.

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Como todo exames, o ecoestresse de vávopatias precisa ter uma pergunta clara antes, para fornecer uma resposta objetiva.

A pior proposta que existe em exames de imagem é não ter uma pergunta específica que gere o exame.

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