General measures
- The following also applies to children with congenital heart defects: at least 1 hour of physical activity daily!A study was able to show that physical activity is often restricted on medical advice; there is thus an urgent need for action here.For information on exercise, see the respective heart valve defects.
- During pregnancy, the patient should also be continuously cardiological care.
Aortic valve
The aortic valve sits between the left ventricle and the aorta.
Aortic stenosis (opening of the aortic valve is narrowed).
- Avoidance of heavy physical exertion
- Both recreational and competitive sports are possible for patients with mild aortic valve stenosis [guidelines: ESC].
- For severe aortic valve stenosis: patients should not participate in either recreational or competitive sports of moderate to high intensity [guidelines: ESC].
- Endocarditis prophylaxis during bloody procedures* and febrile infections.
Aortic insufficiency (aortic valve does not close completely).
- Continue physical activity, avoid very heavy exertion in asymptomatic individuals with significant aortic regurgitation
* Dental procedures (e.g., scaling, root canals) involving injury to ther mucosa (oral mucosa), gingiva (gums), or apical dental apparatus (root apex); furthermore, tonsillectomies (removal of the palatine tonsil) and adenectomies (polyp removal).
Mitral valve
The mitral valve connects the left atrium (ventricle) to the left ventricle (atrium).
Mitral stenosis (opening of the mitral valve is narrowed).
- Physical rest
- Anticoagulation (giving blood thinners) must be given for atrial fibrillation.
- Endocarditis prophylaxis for bloody procedures* and febrile infections.
Mitral regurgitation (mitral valve does not close completely).
- Physical rest
- Anticoagulation must be given if atrial fibrillation is present.
- Endocarditis prophylaxis during bloody procedures* and febrile infections.
Mitral prolapse (protrusion of portions of the mitral valve into the left atrium during systole).
- Low risk: does not require therapy; exercise is allowed
- High risk:
- Normalize weight
- Avoid coffee, alcohol, nicotine
- Avoid sports, physical stress
Mitral valve regurgitation*
- Patients with mild mitral valve regurgitation can participate in all sports [guidelines: ESC].
- Patients with severe mitral valve regurgitation: no competitive sports if LVEF (left ventricular ejection fraction; measure of left ventricular systolic function) <60 percent.
* Mitral valve regurgitation is the insufficiency of the mitral valve causing blood flow from the LV (left ventricle/left ventricle) into the left atrium during ventricular systole (phase of contraction of the heart muscle (in this case, ventricle/ventricle) with ejection of blood).
Interventional therapy procedures (see “Surgical therapy” below)
Aortic stenosis (opening of the aortic valve is narrowed).
- Balloon valvuloplasty (valve disruption) indicated only in young individuals (temporary measure only)
- Transcatheter aortic implantation – insertion of the biological valve replacement via the inguinal artery.
Mitral stenosis (opening of the mitral valve is narrowed).
- Mitral valvuloplasty – blasting of the mitral valve with a balloon catheter.
Mitral regurgitation (mitral valve does not close completely).
- Minimally invasive mitral valve reconstruction
