Atrial septal defect medical therapy: Difference between revisions
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(New page: {{Template:Atrial septal defect}} {{CMG}} ==Medical therapy== There are no widely-used guidelines for medical therapy usage in patients with atrial septal defects. Medical therapy can be ...) |
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===Medical therapy for stroke=== | ===Medical therapy for stroke=== | ||
Researchers have investigated the justification for aspirin therapy in patients with atrial septal defects, such as [[Atrial septal defect patent foramen ovale|Patent foramen ovale]], who have had stroke or a transient ischemic attack.<ref name="pmid11742048">{{cite journal| author=Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G et al.| title=Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 24 | pages= 1740-6 | pmid=11742048 | doi=10.1056/NEJMoa011503 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11742048 }} </ref> | Researchers have investigated the justification for aspirin therapy in patients with atrial septal defects, such as [[Atrial septal defect patent foramen ovale|Patent foramen ovale (PFO)]], who have had stroke or a transient ischemic attack.<ref name="pmid11742048">{{cite journal| author=Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G et al.| title=Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 24 | pages= 1740-6 | pmid=11742048 | doi=10.1056/NEJMoa011503 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11742048 }} </ref> | ||
Aspirin therapy was observed to have an effective role in reducing the incidence of recurrent stroke after four years.<ref name="pmid11742048">{{cite journal| author=Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G et al.| title=Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 24 | pages= 1740-6 | pmid=11742048 | doi=10.1056/NEJMoa011503 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11742048 }} </ref> Another pharmacologic intervention study indicated a supportive stance on utilizing pharmacologic therapies | Aspirin therapy was observed to have an effective role in reducing the incidence of recurrent stroke after four years.<ref name="pmid11742048">{{cite journal| author=Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G et al.| title=Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both. | journal=N Engl J Med | year= 2001 | volume= 345 | issue= 24 | pages= 1740-6 | pmid=11742048 | doi=10.1056/NEJMoa011503 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11742048 }} </ref> Another pharmacologic intervention study also indicated a supportive stance on utilizing pharmacologic therapies to reduce the risk of stroke. This study observed that aspirin therapy and warfarin therapy was effective <ref name="pmid12045168">{{cite journal| author=Homma S, Sacco RL, Di Tullio MR, Sciacca RR, Mohr JP, PFO in Cryptogenic Stroke Study (PICSS) Investigators| title=Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study. | journal=Circulation | year= 2002 | volume= 105 | issue= 22 | pages= 2625-31 | pmid=12045168 | doi= | pmc= | url= }} </ref> The AHA guidelines support the utilization of sustained warfarin therapy in high-risk atrial septal defect patients. <ref name="pmid20966421">{{cite journal| author=Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC et al.| title=Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association. | journal=Stroke | year= 2011 | volume= 42 | issue= 1 | pages= 227-76 | pmid=20966421 | doi=10.1161/STR.0b013e3181f7d043 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20966421 }} </ref> American College of Chest Physicians recommends utilizing antiplatelet therapy for some patent foramen ovale patients.<ref name="pmid18574275">{{cite journal| author=Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P, American College of Chest Physicians| title=Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). | journal=Chest | year= 2008 | volume= 133 | issue= 6 Suppl | pages= 630S-669S | pmid=18574275 | doi=10.1378/chest.08-0720 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18574275 }} </ref> Anticoagulation therapy for patent foramen ovale patients, specifically ones with pulmonary embolus or deep vein thrombosis. | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical therapy
There are no widely-used guidelines for medical therapy usage in patients with atrial septal defects. Medical therapy can be used, however, to manage conditions associated with atrial septal defects.
Medical therapy for stroke
Researchers have investigated the justification for aspirin therapy in patients with atrial septal defects, such as Patent foramen ovale (PFO), who have had stroke or a transient ischemic attack.[1]
Aspirin therapy was observed to have an effective role in reducing the incidence of recurrent stroke after four years.[1] Another pharmacologic intervention study also indicated a supportive stance on utilizing pharmacologic therapies to reduce the risk of stroke. This study observed that aspirin therapy and warfarin therapy was effective [2] The AHA guidelines support the utilization of sustained warfarin therapy in high-risk atrial septal defect patients. [3] American College of Chest Physicians recommends utilizing antiplatelet therapy for some patent foramen ovale patients.[4] Anticoagulation therapy for patent foramen ovale patients, specifically ones with pulmonary embolus or deep vein thrombosis.
References
- ↑ 1.0 1.1 Mas JL, Arquizan C, Lamy C, Zuber M, Cabanes L, Derumeaux G; et al. (2001). "Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both". N Engl J Med. 345 (24): 1740–6. doi:10.1056/NEJMoa011503. PMID 11742048.
- ↑ Homma S, Sacco RL, Di Tullio MR, Sciacca RR, Mohr JP, PFO in Cryptogenic Stroke Study (PICSS) Investigators (2002). "Effect of medical treatment in stroke patients with patent foramen ovale: patent foramen ovale in Cryptogenic Stroke Study". Circulation. 105 (22): 2625–31. PMID 12045168.
- ↑ Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC; et al. (2011). "Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association". Stroke. 42 (1): 227–76. doi:10.1161/STR.0b013e3181f7d043. PMID 20966421.
- ↑ Albers GW, Amarenco P, Easton JD, Sacco RL, Teal P, American College of Chest Physicians (2008). "Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)". Chest. 133 (6 Suppl): 630S–669S. doi:10.1378/chest.08-0720. PMID 18574275.