Atrial septal defect medical therapy: Difference between revisions
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Class I | '''Class I''' | ||
1 Cardioversion after appropriate anticoagulation is recommended to attempt restoration of the sinus rhythm if atrial fibrillation occurs. (Level of Evidence: A) | 1 Cardioversion after appropriate anticoagulation is recommended to attempt restoration of the sinus rhythm if atrial fibrillation occurs. (Level of Evidence: A) | ||
Revision as of 19:15, 23 August 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
There is no industry-standard for utilizing medical therapy in atrial septal defect patients. Medical therapy is often used to manage comorbidity complexes associated with atrial septal defect such as stroke and migraine.
Medical therapy
There are no widely used guidelines for medical therapy usage in patients with atrial septal defects. Medical therapy in patients of atrial septal defect is administered in certain conditions like arrhythmias. Also, medical therapy can be used to manage conditions associated with atrial septal defects.
- In asymptomatic patients with small shunts and normal right ventricle size generally no medical therapy is required. Routine follow-up assessment of symptoms like arrhythmia, paradoxical embolic events should be done. Also, a repeat echocardiogram should be obtained every 2 to 3 years.
- Treatment of atrial arrhythmia and restoration of sinus rhythm is recommended. In cases with atrial fibrillation, antiarrhythmic and anticoagulation therapy is recommended.
ACC/AHA recommendations for reproduction in patients with atrial septal defects[1](DONOT EDIT)
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Class I 1 Cardioversion after appropriate anticoagulation is recommended to attempt restoration of the sinus rhythm if atrial fibrillation occurs. (Level of Evidence: A) 2 Rate control and anticoagulation are recommended if sinus rhythm cannot be maintained by medical or interventional means. (Level of Evidence: A)
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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, who have had stroke or a transient ischemic attack.[2]
- Aspirin therapy was observed to have an effective role in reducing the incidence of recurrent stroke after four years.[2]
- Another pharmacologic intervention study indicated that aspirin and warfarin therapy were effective [3]
- The AHA guidelines support the utilization of sustained warfarin therapy in high-risk atrial septal defect patients. [4] American College of Chest Physicians recommends utilizing antiplatelet therapy for some patent foramen ovale patients.[5] Anticoagulation therapy for patent foramen ovale patients, specifically ones with pulmonary embolus or deep vein thrombosis.
Medical therapy for migraines
See also
References
- ↑ Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.
- ↑ 2.0 2.1 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.