Acute aortic regurgitation medical therapy

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Patients with acute severe aortic insufficiency are usually managed with emergency aortic valve replacement/repair. However they can be stabilized medically before surgery with vasodilators such as nitroprusside which lowers after load and thereby reduces retrograde flow and left ventricular end diastolic pressure. Inotropic agents such as dopamine and dobutamine can also be used to increase the contractility of heart resulting in improved forward flow.

Beta blockers which are often used in managing aortic dissection should be used very cautiously in the presence of acute aortic insufficiency as beta blockers can block the compensatory tachycardia and worsen the cardiac output.

Patients who are hemodynamically stable with mild aortic insufficiency secondary to infective endocarditis can be managed with antibiotics alone.