Valvular Heart Disease

Suraj Achar, MD, FAAFP

Suraj Achar, MD, FAAFP

TIME AND PLACE: 7:30-8:30 a.m. Thursday, Hemisfair Ballroom C1; and 3:30-4:30 p.m. Thursday, Hemisfair Ballroom C1

ABOUT THE PRESENTER: Suraj Achar, MD, FAAFP, is a professor of family medicine and public health at the University of California, San Diego, and practices family medicine and sports medicine in the San Diego area. He has presented at FMX and Assembly for about a decade. This summer, he competed with the United States Medical Soccer Team in the World Medical Football Championship in Austria.

SESSION OVERVIEW: Achar will talk about how evidence-based medicine and guidelines for treating valvular heart disease (VHD) have evolved in recent years while providing a refresher about the different causes, such as calcified valves, rheumatic heart disease and endocarditis. He also will review diagnosis and treatment for special populations, including patients with collagen vascular disease such as Marfans and those that are pregnant.

"We must also consider the rapidly aging population worldwide that faces a greater likelihood of disease caused by valve degeneration," he said.

WHY THIS SESSION MATTERS TO FAMILY PHYSICIANS: Family physicians learn about VHD in medical school, but that's often the last time the topic comes up in a learning setting. But valvular heart disease is commonly seen, with about 50,000 valvular heart surgeries a year, Achar said.

"My job is to kind of connect the dots," he said. "So that means we're going to talk about the basics from murmurs to indications for advanced imaging such as cardiac MRI, and what's changed since our training in medical school: What are the new innovations, the new technologies that are out there?"

TAKE HOME MESSAGES: Valvular heart disease (VHD) may seem confusing, but most patients just require careful monitoring until they become symptomatic, Achar said. The asymptomatic phase generally last a long time, but the onset of symptoms calls for greater urgency and intervention, as morbidity and mortality rapidly increases without surgical intervention.

"Once patients become symptomatic with VHD, they need to be referred to a cardiologist and cardo-thoracic specialty team, to figure out when, and if, they need invasive treatment," he said.

Rheumatic heart disease doesn't occur much in the U.S. population today, Achar said, but family physicians need to be aware that immigrant populations may present with the disease as it is still common in developing nations.

ALSO OF NOTE: Issues related to the heart go right to the core of what it means to be a family physician, Achar said, and the stethoscope is the symbol of being a doctor. The session will include a review of how to properly auscultate the heart and other clinical signs of VHD.

"The very first thing a medical student buys when they get accepted to medical school is a stethoscope," said Achar, who on Saturday will present the "Peripheral Neuropathy" session.