Mitral regurgitation treatment overview

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

• 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.

• Based on age of patient, co-morbidities, symptoms and severity of mitral regurgitation, risks and benefits of valve surgery should be considered.

References

Template:WikiDoc Sources