Cardiovascular Disease: Valvular Heart Disease

sec_arr Aortic Regurgitation
SECTIONS

Aortic Regurgitation

LEOs undergoing initial evaluation for aortic regurgitation can be cleared for full duty if they meet all of the following criteria: 

  • Asymptomatic (e.g., no symptoms of reduced cardiac output, no signs of arterial emboli, etc.) 
  • Recent (within the past 12 months) ECG with normal sinus rhythm 
  • Recent (within the past 12 months) EST to at least 12 METS with normal findings11,12 
  • Recent (within the past 12 months) echocardiogram showing Stage A or Stage B of chronic aortic regurgitation (Table 4) 

Follow-up Evaluation for Aortic Regurgitation: LEOs with aortic regurgitation should have an annual evaluation by a cardiologist or other physician knowledgeable in the treatment of cardiac valvular disease. For individuals who are asymptomatic with normal left ventricular function, the frequency of follow-up echocardiogram is determined by the severity of the regurgitation. For Stage A or mild Stage B, echocardiograms should be performed every 3-5 years. For moderate Stage B, echocardiograms should be performed every 1-2 years.1 Results of both the physician evaluations and the echocardiograms should be shared with the agency’s medical provider. 

Post-aortic Valve Repair: LEOs undergoing an aortic valve repair should be put on restrictions for 3 months post-procedure,5,6 and can be cleared for full duty when they have met all the following criteria post procedure: 

  • Asymptomatic (e.g., no symptoms of reduced cardiac output, no signs of arterial emboli, etc.) 
  • ECG with normal sinus rhythm 
  • EST to at least 12 METS with normal findings 
  • Baseline (1-3 months post procedure) echocardiogram meeting Stage A or Stage B criteria (Table 4) 
  • Off all anticoagulant medications 
  • Healed surgical site. 

Follow-up Evaluation for Aortic Valve Repair: LEOs who have undergone an aortic valve repair should have an annual evaluation by a cardiologist or other physician knowledgeable in the treatment of cardiac valvular disease. Follow-up echocardiograms should be done at the discretion of the cardiologist or other physician knowledgeable in the treatment of aortic valve repairs. Results of the physician evaluations and the echocardiograms should be shared with the agency’s medical provider. 

Aortic Valve Implants/Replacements: See the last section of this chapter.