Mitral Regurgitation Treatment: Difference between revisions
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'''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S ; [[Lakshmi Gopalakrishnan]], M.B.B.S | '''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S ; [[Lakshmi Gopalakrishnan]], M.B.B.S | ||
*[[ | ==Overview of Treatment of Mitral Regurgitation== | ||
* In patients with mitral regurgitation (acute or chronic) with hemodynamic instability, an electrocardiogram should be done to assess for the presence of [[Myocardial Infarction]]. In its absence, [[infective endocarditis]] should be excluded by drawing blood cultures and ordering an echocardiogram. | |||
* | * [[Diuretics]] should be administered to patients with [[pulmonary congestion]]. | ||
* | * Afterload reduction should be instituted through the use of [[vasodilators]] such as [[ACE inhibitors]]. | ||
* | * In the presence of [[atrial fibrillation]], [[beta blocker]], [[calcium channel blocker]] or [[digoxin]] can be administered to slow the heart rate down and improve left ventricular filling. | ||
*Prophylactic antibiotics prior periodontal procedure which involves manipulation of gingival tissue, the periapical region of a tooth, or perforation of oral mucosa is recommended in patients with previous infective endocarditis, prosthetic mitral valve and congentital heart disease.<ref name="pmid17446442">{{cite journal |author=Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT |title=Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group |journal=[[Circulation]] |volume=116 |issue=15 |pages=1736–54 |year=2007 |month=October |pmid=17446442 |doi=10.1161/CIRCULATIONAHA.106.183095 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17446442 |accessdate=2011-03-16}}</ref> | * Anti-coagulation therapy should be considered in patients with [[atrial fibrillation]] and in patients with prosthetic [[mitral valve replacement]] surgery. | ||
* Prophylactic antibiotics prior to a periodontal procedure which involves manipulation of gingival tissue, the periapical region of a tooth, or perforation of oral mucosa is recommended in patients with previous infective endocarditis, patients who have a prosthetic mitral valve implanted and in those with congentital heart disease.<ref name="pmid17446442">{{cite journal |author=Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT |title=Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group |journal=[[Circulation]] |volume=116 |issue=15 |pages=1736–54 |year=2007 |month=October |pmid=17446442 |doi=10.1161/CIRCULATIONAHA.106.183095 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=17446442 |accessdate=2011-03-16}}</ref> | |||
*Based on age of patient, co-morbidities, symptoms and severity of mitral regurgitation, risks and benefits of valve surgery should be considered. | *Based on age of patient, co-morbidities, symptoms and severity of mitral regurgitation, risks and benefits of valve surgery should be considered. | ||
Latest revision as of 17:28, 9 August 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S ; Lakshmi Gopalakrishnan, M.B.B.S
Overview of Treatment of Mitral Regurgitation
- In patients with mitral regurgitation (acute or chronic) with hemodynamic instability, an electrocardiogram should be done to assess for the presence of Myocardial Infarction. In its absence, infective endocarditis should be excluded by drawing blood cultures and ordering an echocardiogram.
- Diuretics should be administered to patients with pulmonary congestion.
- Afterload reduction should be instituted through the use of vasodilators such as ACE inhibitors.
- In the presence of atrial fibrillation, beta blocker, calcium channel blocker or digoxin can be administered to slow the heart rate down and improve left ventricular filling.
- Anti-coagulation therapy should be considered in patients with atrial fibrillation and in patients with prosthetic mitral valve replacement surgery.
- Prophylactic antibiotics prior to a periodontal procedure which involves manipulation of gingival tissue, the periapical region of a tooth, or perforation of oral mucosa is recommended in patients with previous infective endocarditis, patients who have a prosthetic mitral valve implanted and in those with congentital heart disease.[1]
- Based on age of patient, co-morbidities, symptoms and severity of mitral regurgitation, risks and benefits of valve surgery should be considered.
Acute Mitral Regurgitation | Chronic Mitral Regurgitation
References
- ↑ Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bolger A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT (2007). "Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group". Circulation. 116 (15): 1736–54. doi:10.1161/CIRCULATIONAHA.106.183095. PMID 17446442. Retrieved 2011-03-16. Unknown parameter
|month=ignored (help)