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
The choice of treatment depends on the symptoms present and the condition and function of the heart. Patients with high blood pressure or a weakened heart muscle may be given medications to reduce the strain on the heart and help improve the condition.
Digitalis may be used to strengthen the heartbeat, along with diuretics (water pills) to remove excess fluid in the lungs.
A low-sodium diet may be helpful. Most people have no symptoms; but if a person develops symptoms, activity may be restricted.
Hospitalization may be required for diagnosis and treatment of severe symptoms. Surgical repair or replacement of the valve is recommended if heart function is poor, symptoms are severe, or the condition gets worse. Once the diagnosis of mitral regurgitation is made, the patient should have regular follow-ups with a specialist to determine whether he or she need surgery.
- 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.
- 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.
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
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