Valvular Heart Disease: Pathologic, Echocardiographic and Surgical Correlations

To most physicians who completed their medical training within the last 40 years, few areas of medicine have seen more dramatic changes than in the diagnostic evaluation and treatment of valvular heart disease. Earlier in this century, because of the high worldwide incidence of rheumatic fever, almost all examples of valve stenosis or incompetence were assumed to have a rheumatic basis. Indeed, except for the occasional necropsy case demonstrating either a congenitally malformed valve or one structurally altered by other more virulent infectious processes, these assumptions were often accurate. Nowadays, however, with the advent of more sophisticated modalities such as doppler echo cardiography and color flow imaging techniques earlier medical and surgical interventions are possible.