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Degenerative Mitral Valve Disease (view source)
Revision as of 19:39, 15 November 2010
, 19:39, 15 November 2010→Treatment
No treatment is recommended prior to the onset of heart failure. Treatment is aimed at managing congestive heart failure through a combination of drugs.
No treatment is recommended prior to the onset of heart failure. Treatment is aimed at managing congestive heart failure through a combination of drugs.
The aims of treatment are to:
The aims of treatment are to:
#1 '''Reduce Preload'''
# '''Reduce Preload'''
*Diuretics to reduce circulating fluid volume (Frusemide, Benzofluazide, Spironolactone, Amiloride)
*Diuretics to reduce circulating fluid volume (Frusemide, Benzofluazide, Spironolactone, Amiloride)
*Vasodilators to reduce venous return (Nitrates, ACE inhibitors, Alpha antagonists)
*Vasodilators to reduce venous return (Nitrates, ACE inhibitors, Alpha antagonists)
#2 '''Reduce Afterload
# '''Reduce Afterload
*Vasodilators to decrease systemic vascular resistance
*Vasodilators to decrease systemic vascular resistance
**ACE inhibitors e.g. Enalapril, Benzapril, Imidopril ,
**ACE inhibitors e.g. Enalapril, Benzapril, Imidopril ,
**Calcium channel blockers e.g. Amlodipine
**Calcium channel blockers e.g. Amlodipine
**Nitrates e.g. Nitropusside
**Nitrates e.g. Nitropusside
#3 '''Enhance Systolic function
# '''Enhance Systolic function
*Positive Inotropes to increase cardiac contractility and increase cardiac output.
*Positive Inotropes to increase cardiac contractility and increase cardiac output.
**Pimobendan
**Pimobendan
**Dobutamine
**Dobutamine
**Xanthines
**Xanthines
#4 '''Improve Diastolic function
# '''Improve Diastolic function
*Negative Chronotropes to increase the length of diastole (digoxin, atenolol)
*Negative Chronotropes to increase the length of diastole (digoxin, atenolol)
*Calcium channel blockers to improve relaxation (amlodipine)
*Calcium channel blockers to improve relaxation (amlodipine)
#5 '''Control cardiac arrhythmias using anti-arhythmic drugs
# '''Control cardiac arrhythmias using anti-arhythmic drugs
==Prognosis==
==Prognosis==