Ventricular septal defect medical therapy: Difference between revisions
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(/* Recommendation for Medical Therapy (DO NOT EDIT){{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a rep...) |
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{{Ventricular septal defect}} | {{Ventricular septal defect}} | ||
{{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] | {{CMG}}; '''Associate Editors-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, MBBS]] [mailto:psingh13579@gmail.com]; {{CZ}}; '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
==Medical Therapy== | ==Medical Therapy== | ||
If the defect is small, no treatment is usually needed. However, the baby should be closely monitored by a health care provider to make sure that the hole eventually closes properly and signs of heart failure do not occur. | If the defect is small, no treatment is usually needed. However, the baby should be closely monitored by a health care provider to make sure that the hole eventually closes properly and signs of heart failure do not occur. | ||
Babies with a large VSD who have symptoms related to heart failure may need medicine to control the symptoms and surgery to close the hole. | Babies with a large VSD who have symptoms related to [[heart failure]] may need medicine to control the symptoms and surgery to close the hole. | ||
* Dietary interventions may facilitate weight gain in infants with moderate to large VSDs. The calorie density of feedings may be increased in the setting of failure to thrive and supplementary iron should be given to infants with iron deficiency anemia to increase hematocrit and oxygen carrying capacity of blood. | * Dietary interventions may facilitate weight gain in infants with moderate to large VSDs. The calorie density of feedings may be increased in the setting of failure to thrive and supplementary iron should be given to infants with iron deficiency [[anemia]] to increase [[hematocrit]] and oxygen carrying capacity of blood. | ||
* | * [[Diuretic]]s are the first line of therapy in patients with features of [[congestive heart failure]]. [[Furosemide]] (1-2 mg/day per dose two to three times a day) is commonly used. | ||
* ACE inhibitors like captopril and enalapril are used to reduce the systemic vascular resistance, thus reducing afterload. | * ACE inhibitors like [[captopril]] and [[enalapril]] are used to reduce the systemic vascular resistance, thus reducing [[afterload]]. | ||
* Digoxin are used by some physicians to increase the contractility in large shunt lesions. | * [[Digoxin]] are used by some physicians to increase the [[contractility]] in large shunt lesions. | ||
==2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref> == | ==2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref> == | ||
===Recommendation for Medical Therapy (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref>=== | ===Recommendation for Medical Therapy (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref>=== | ||
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Pulmonary]] [[vasodilator]] therapy may be considered for adults with VSDs with progressive/severe pulmonary [[vascular disease]] (refer to the [[National Guideline Clearinghouse]] [NGC] summary of the ACC/AHA guideline, [[Pulmonary Hypertension]]/Eisenmenger Physiology).''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[Pulmonary]] [[vasodilator]] therapy may be considered for adults with VSDs with progressive/severe pulmonary [[vascular disease]] (refer to the [[National Guideline Clearinghouse]] [NGC] summary of the ACC/AHA guideline, [[Pulmonary Hypertension]]/Eisenmenger Physiology). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | ||
|} | |} | ||
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[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Needs overview]] | |||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
Latest revision as of 18:09, 8 January 2013
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Ventricular septal defect Microchapters | |
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Differentiating Ventricular Septal Defect from other Diseases | |
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Diagnosis | |
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ACC/AHA Guidelines for Surgical and Catheter Intervention Follow-Up | |
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Ventricular septal defect medical therapy On the Web | |
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Risk calculators and risk factors for Ventricular septal defect medical therapy | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, MBBS [2]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Medical Therapy
If the defect is small, no treatment is usually needed. However, the baby should be closely monitored by a health care provider to make sure that the hole eventually closes properly and signs of heart failure do not occur.
Babies with a large VSD who have symptoms related to heart failure may need medicine to control the symptoms and surgery to close the hole.
- Dietary interventions may facilitate weight gain in infants with moderate to large VSDs. The calorie density of feedings may be increased in the setting of failure to thrive and supplementary iron should be given to infants with iron deficiency anemia to increase hematocrit and oxygen carrying capacity of blood.
- Diuretics are the first line of therapy in patients with features of congestive heart failure. Furosemide (1-2 mg/day per dose two to three times a day) is commonly used.
- ACE inhibitors like captopril and enalapril are used to reduce the systemic vascular resistance, thus reducing afterload.
- Digoxin are used by some physicians to increase the contractility in large shunt lesions.
2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1]
Recommendation for Medical Therapy (DO NOT EDIT)[1]
| Class IIb |
| "1. Pulmonary vasodilator therapy may be considered for adults with VSDs with progressive/severe pulmonary vascular disease (refer to the National Guideline Clearinghouse [NGC] summary of the ACC/AHA guideline, Pulmonary Hypertension/Eisenmenger Physiology). (Level of Evidence: B) " |
References
- ↑ 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.