Pulmonary regurgitation medical therapy
Pulmonic regurgitation Microchapters
Treatment of pulmonic regurgitation may be divided into medical and surgical treatment. Medical management of pulmonic regurgitation may include use of diuretics in patients with RV dysfunction. ACE inhibitors and beta blockers may be used to reverse neurohormonal activation and improve symptoms. Antibiotic prophylaxis may be indicated in certain conditions such as patients with cyanotic heart disease, prosthetic heart valves, rheumatic heart disease, and patients previously having sustained bacterial endocarditis.
- There are no specific medical measures for management of PR.
- Diuretics are recommended in patients with RV dysfunction for maintenance of fluid balance.
- In patients with repaired tetralogy of fallot, ACE inhibitors or beta-blockers are used to reverse the neuroharmonal activation and improve the symptoms.
The American Heart Association Recommendations on Prevention of Bacterial Endocarditis indicate that antibiotic prophylaxis is not necessary for pulmonic regurgitation in those patients with otherwise structurally normal pulmonic valves, particularly if there is no diastolic murmur. It should be noted, though, that those patients with the following conditions may warrant antibiotic prophylaxis:
- Complex cyanotic heart disease
- Prosthetic heart valves
- Patients with congenital heart disease and pulmonic regurgitation
- Acquired pulmonic valve regurgitation as the result of rheumatic heart disease
- Patients with complex cyanotic heart disease
- In patients who have previously sustained bacterial endocarditis
- Bolger AP, Sharma R, Li W, Leenarts M, Kalra PR, Kemp M; et al. (2002). "Neurohormonal activation and the chronic heart failure syndrome in adults with congenital heart disease". Circulation. 106 (1): 92–9. PMID 12093776.
- Davos CH, Davlouros PA, Wensel R, Francis D, Davies LC, Kilner PJ; et al. (2002). "Global impairment of cardiac autonomic nervous activity late after repair of tetralogy of Fallot". Circulation. 106 (12 Suppl 1): I69–75. PMID 12354712.
- Seiler C (2004). "Management and follow up of prosthetic heart valves". Heart. 90 (7): 818–24. doi:10.1136/hrt.2003.025049. PMC 1768319. PMID 15201262.