Acute aortic regurgitation medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

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[1].

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.

Reference

  1. Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Retrieved 2011-04-07. Unknown parameter |month= ignored (help)

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