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Aortic Coarctation Medication

  • Author: Sandy N Shah, DO, MBA, FACC, FACP, FACOI; Chief Editor: Park W Willis IV, MD  more...
 
Updated: Mar 27, 2014
 

Medication Summary

No specific medications are used to treat coarctation of the aorta because it is a mechanical obstruction. In the neonate, management of concomitant congestive heart failure may include prostaglandin E1 to maintain patency of the ductus arteriosus. Beyond the neonatal period, management of congestive heart failure may include digoxin and diuretics.

Hypertension should be controlled by beta-blockers, ACE inhibitors, or angiotensin-receptor blockers as first-line medications. The choice of beta-blockers or vasodilators may be influenced in part by the aortic root size, the presence of aortic regurgitation, or both.[1]

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Prostaglandins

Class Summary

This agent promotes vasodilatation by direct effect on the vasculature and smooth muscle of the ductus arteriosus.

Alprostadil intracavernous/urethral (Prostin VR)

 

Used to maintain patency of ductus arteriosus when cyanotic lesion or interrupted aortic arch presents in newborn. Most effective in premature infants.

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Cardiac glycosides

Class Summary

These agents increase the contractility of cardiac muscle in a dose-dependent manner (ie, positive inotropic effect).

Digoxin (Lanoxin)

 

Cardiac glycoside with direct inotropic effects in addition to indirect effects on cardiovascular system. Acts directly on cardiac muscle, increasing myocardial systolic contractions. Its indirect actions result in increased carotid sinus nerve activity and enhanced sympathetic withdrawal for any given increase in mean arterial pressure.

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Loop diuretics

Class Summary

These agents inhibit electrolyte reabsorption in the thick ascending limb of the loop of Henle, thus promoting diuresis.

Furosemide (Lasix)

 

Commonly used diuretic with moderate diuretic potency.

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Contributor Information and Disclosures
Author

Sandy N Shah, DO, MBA, FACC, FACP, FACOI Cardiologist

Sandy N Shah, DO, MBA, FACC, FACP, FACOI is a member of the following medical societies: American College of Cardiology, American College of Osteopathic Internists, American College of Physicians, American Osteopathic Association, Society for Cardiovascular Angiography and Interventions, American Society of Nuclear Cardiology, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Arti N Shah, MD, MS, FACC Assistant Professor of Medicine, Mount Sinai School of Medicine; Director of Electrophysiology, Elmhurst Hospital Center, Queens Hospital Center, Queens Health Network

Arti N Shah, MD, MS, FACC is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, European Society of Cardiology, Heart Rhythm Society, Cardiac Electrophysiology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Frank M Sheridan, MD 

Frank M Sheridan, MD is a member of the following medical societies: American College of Cardiology, American Heart Association, Society for Cardiovascular Angiography and Interventions

Disclosure: Nothing to disclose.

Chief Editor

Park W Willis IV, MD Sarah Graham Distinguished Professor of Medicine and Pediatrics, University of North Carolina at Chapel Hill School of Medicine

Park W Willis IV, MD is a member of the following medical societies: American Society of Echocardiography

Disclosure: Nothing to disclose.

References
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