Left ventricular aneurysm medical therapy: Difference between revisions

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{{Left ventricular aneurysm}}
{{Left ventricular aneurysm}}
{{CMG}}
{{CMG}};{{AE}}{{MehdiP}}
 
==Overview==
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[[Afterload]] reduction and treatment of [[Angina Pectoris|anginal pain]], are the mainstay of medical therapy for small and medium-sized LV aneurysms.
 
==Medical Therapy==
==Medical Therapy==
==2004 ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction (DO NOT EDIT)<ref name="pmid15339869">{{cite journal |author=Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK |title=ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction) |journal=Circulation |volume=110 |issue=9 |pages=e82–292 |year=2004 |month=August |pmid=15339869 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15339869}}</ref>==
Medical therapy is indicated for small and medium-sized LV aneurysms. The aim of medical therapy is to decrease cardiac work load (afterload reduction), provide anti ischemic therapy for [[chest pain]], and [[Anti coagulation therapy|anti coagulation]] if [[Thrombosis|mural thrombosis]] exist.<ref name="brawn">{{cite book | last = Mann | first = Douglas | title = Braunwald's heart disease : a textbook of cardiovascular medicine | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455751341 }}</ref>
 
*[[Afterload]] reduction:
===Left Ventricular Aneurysm (DO NOT EDIT)<ref name="pmid15339869">{{cite journal|author=Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK |title=ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction) |journal=Circulation |volume=110 |issue=9|pages=e82–292 |year=2004 |month=August |pmid=15339869 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15339869}}</ref>===
:[[ACE inhibitor|ACE inhibitors]] are the drug of choice for decreasing the [[afterload]].
*Anti ischemic therapy:
:Many medications can be used to treat the underlying ischemic event, and also decrease the ischemic burden. Examples of such medications include:<ref name="brawn">{{cite book | last = Mann | first = Douglas | title = Braunwald's heart disease : a textbook of cardiovascular medicine | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2015 | isbn = 978-1455751341 }}</ref>
:'''[[Chronic stable angina nitrate therapy|Nitrates]] | [[Chronic stable angina beta blocker therapy|Beta Blockers]] | [[Chronic stable angina treatment calcium channel blockers|Calcium Channel Blockers]] | [[Chronic stable angina treatment potassium channel openers|Potassium Channel Openers]] | [[Chronic stable angina newer antianginal agents|Newer Anti-anginal Agents]]'''


{| class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable that patients with [[STEMI]] who develop a ventricular aneurysm associated with intractable [[ventricular tachyarrhythmia]]s and/or [[pump failure]] unresponsive to medical and catheter based therapy be considered for [[LV]] aneurysmectomy and [[CABG]] surgery. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}


==References==
==References==

Latest revision as of 05:29, 9 April 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Afterload reduction and treatment of anginal pain, are the mainstay of medical therapy for small and medium-sized LV aneurysms.

Medical Therapy

Medical therapy is indicated for small and medium-sized LV aneurysms. The aim of medical therapy is to decrease cardiac work load (afterload reduction), provide anti ischemic therapy for chest pain, and anti coagulation if mural thrombosis exist.[1]

ACE inhibitors are the drug of choice for decreasing the afterload.
  • Anti ischemic therapy:
Many medications can be used to treat the underlying ischemic event, and also decrease the ischemic burden. Examples of such medications include:[1]
Nitrates | Beta Blockers | Calcium Channel Blockers | Potassium Channel Openers | Newer Anti-anginal Agents


References

  1. 1.0 1.1 Mann, Douglas (2015). Braunwald's heart disease : a textbook of cardiovascular medicine. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455751341.


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