Cardiovascular Disease: Valvular Heart Disease

sec_arr Aortic Stenosis
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Aortic Stenosis

LEOs undergoing initial evaluation for aortic stenosis 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 findings* 
  • Recent (within the past 12 months) echocardiogram showing Stage A or Stage B of aortic stenosis (Table 3). 

Follow-up Evaluation for Aortic Stenosis: LEOs with aortic stenosis 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 stenosis. For Stage A, echocardiograms should be performed every 3-5 years. For Stage B, echocardiograms should be performed every 1-2 years.1 Results of 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 3)1 
  • 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. The results of both 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.