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...)
(/* 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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| 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]]
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| 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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Revision as of 16:57, 8 November 2012

Ventricular septal defect Microchapters

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Overview

Classification

Pathophysiology

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Differentiating Ventricular Septal Defect from other Diseases

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Medical Therapy

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Ventricular septal defect post-surgical prognosis

ACC/AHA Guidelines for Surgical and Catheter Intervention Follow-Up

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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]]

Overview

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. 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.


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