Cardiovascular Disease: Valvular Heart Disease

sec_arr Mitral Regurgitation
SECTIONS

Mitral Regurgitation

LEOs undergoing initial evaluation for mitral 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 past 12 months) ECG with normal sinus rhythm 
  • Recent (within past 12 months) EST to at least 12 METS with normal findings 
  • Recent (within past 12 months) echocardiogram showing Stage A or Stage B (Table 2) 

Follow-up Evaluation for Mitral Regurgitation: LEOs with mitral 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 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 both the physician evaluations and the echocardiograms should be shared with the agency’s medical provider. 

Mitral Regurgitation Post Repair: LEOs undergoing a mitral valve regurgitation repair should be put on restrictions for 3 months post-surgery,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 echocardiogram (1-3 months post procedure) meeting Stage A or Stage B criteria (Table 2)1 
  • Off all anticoagulant medications 
  • Healed surgical sites 

Follow-up Evaluation for Mitral Valve Regurgitation Repair: LEOs who have undergone a mitral 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 annually for transcatheter repairs. For surgical repairs, echocardiograms should be done at 1 year and then every 2-3 years.1 Results of both the physician evaluations and echocardiogram should be shared with the agency’s medical provider. 

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