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Previous Volume 351:1539-1546 October 7, 2004 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 48-year-old woman who reports mild fatigue but no dyspnea, chest pain, or palpitation is found to have a diastolic cardiac murmur. The blood pressure is 140/50 mm Hg, and the pulses are bounding. Cardiac examination reveals decreased S1 and increased S2 intensity, with a grade 1/6 systolic murmur and a grade 3/6 diastolic murmur along the left sternal border. Doppler color-flow . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Surgical Management

            Symptomatic Patients

            Asymptomatic Patients

            Risks of Surgery

Nonsurgical Management

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn.

Address reprint requests to Dr. Enriquez-Sarano at the Mayo Clinic, 200 First St. SW, Rochester, MN 55905, or at sarano.maurice@mayo.edu.

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