Acute aortic regurgitation medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

Patients with acute severe aortic insufficiency are usually managed with emergency aortic valve replacement or repair. However, they can be stabilized medically before surgery with vasodilators.

Medical Therapy

Nitroprusside

Nitroprusside lowers afterload and thereby reduces retrograde flow and left ventricular end diastolic pressure.

Inotropic Agents

Inotropic agents such as dopamine and dobutamine can be used to increase the contractility of the heart resulting in improved forward flow.

Beta Blockers

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.

Antibiotics

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

Intraaortic Balloon Pump

Insertion of an intraaortic balloon pump is contraindicated in the treatment of aortic insufficiency, as it may worsen the severity of the regurgitation.