CHAPTER 21 Valvular Heart Disease
Valvular heart disease (VHD), although not as common as coronary disease, heart failure, or hypertension, is an important, and challenging, clinical entity. It is of interest for the following reasons: substantial advances have been made in the understanding of its pathophysiology; important changes in patient characteristics and aetiologies have occurred over recent years; diagnosis is now largely dominated by non-invasive imaging, especially echocardiography which has become the standard to evaluate valve structure and function; and, finally, treatment has not only developed through the continuing progress in prosthetic valve technology, but also has been re-orientated by the development of conservative surgical techniques and the development of interventional cardiology.
This chapter will provide an updated review of the main aspects of each acquired valve disease in adults, and include the important sub-group of patients who have previously undergone valve surgery. It will also present principles of management with regards to diagnosis and treatment that are derived from the most recent guidelines. Useful complements to this chapter can be found in 
Chapters 4 (Cardiac Ultrasound), 10 (Congenital Heart Disease in Children and Adults), 22 (Infective Endocarditis), and 34 (Pregnancy and Heart Disease).
Chapter 28)
