ABSTRACT
Patients with mitral or aortic valve disease constitute an important part of patients in cardiology practice. General practitioners and internists have an important role in the long-term care of these patients. We review current knowledge and recommendations for follow-up, medical therapy and indications for surgery in patients with aortic and mitral valve disease. Asymptomatic patients with valve disease need a clinical and echocardiographic follow-up at specific time intervals. Most patients with mild or moderate valve disease do not need medical or surgical therapy. However, once a patient becomes symptomatic, he needs a non-invasive and likely an invasive evaluation for surgical valve repair or replacement. In case the valve disease progresses without the development of clinical symptoms, the indication for surgery must be derived from hemodynamic parameters, the onset of arrhythmias (atrial fibrillation), and pulmonary hypertension. In symptomatic and asymptomatic severe valve disease specific medical therapy can be very beneficial. However, improvement under medical therapy should not delay a prognostically necessary surgical valve repair or replacement.
