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Valvular heart disease is a relative risk factor for general anaesthesia. Those patients with previous episodes of endocarditis or the presence of prosthetic valves will require prophylaxis in the form of antibiotics and anticoagulation.
Patients with symptomatic aortic valve disease, particularly aortic stenosis, have very little functional reserve and so the risk-benefit equation must be carefully assessed. Mitral valve disease has a more indolent course; an investigation into cardiac function is warranted before proceeding, e.g. echocardiography.