title: Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department.
abstract: OBJECTIVE
  To evaluate the clinical and epidemiological profile of patients with valvular heart disease who arrived decompensated at the emergency department of a university hospital in Brazil.
  
  
  METHODS
  A descriptive analysis of clinical and echocardiographic data of 174 patients with severe valvular disease, who were clinically decompensated and went to the emergency department of a tertiary cardiology hospital, in the State of São Paulo, in 2009.
  
  
  RESULTS
  The mean age of participants was 56 ± 17 years and 54% were female. The main cause of valve disease was rheumatic in 60%, followed by 15% of degenerative aortic disease and mitral valve prolapse in 13%. Mitral regurgitation (27.5%) was the most common isolated valve disease, followed by aortic stenosis (23%), aortic regurgitation (13%) and mitral stenosis (11%). In echocardiographic data, the mean left atrial diameter was 48 ± 12 mm, 38 ± 12 mm for the left ventricular systolic diameter, and 54 ± 12 mm for the diastolic diameter; the mean ejection fraction was 56 ± 13%, and the mean pulmonary artery pressure was 53 ± 1 6 mmHg. Approximately half of patients (44%) presented atrial fibrillation, and over one third of them (37%) had already undergone another cardiac surgery.
  
  
  CONCLUSIONS
  Despite increased comorbidities and age-dependent risk factors commonly described in patients with valvular heart disease, the clinical profile of patients arriving at the emergency department represented a cohort of rheumatic patients in more advanced stages of disease. These patients require priority care in high complexity specialized hospitals.
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Ricardo Casalino Sanches de
authors.initials: RC
authors.lastname: Moraes
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Katz
authors.affiliation: Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Tarasoutchi
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004452:Echocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012216:Rheumatic Diseases / Q000150:complications; D012307:Risk Factors