eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Cardiology

Mitral Valve Insufficiency: Follow-up

Author: Monesha Gupta-Malhotra, MD, MBBS, FAAP, FACC, FASE, Assistant Professor, Division of Pediatric Cardiology, University of Texas Medical School, Children's Memorial Hermann Hospital
Contributor Information and Disclosures

Updated: Feb 1, 2010

Follow-up

Further Inpatient Care

  • In mitral valve insufficiency, use medications to decrease the work placed on the heart. Intravenous diuretics can be used. Intravenous inotropes (eg, milrinone) can also be used to treat heart failure.

Further Outpatient Care

  • Asymptomatic patients and those with normal chest radiograph, ECG, and echocardiography findings should have follow-up evaluations at regular intervals.
  • Patients without severe symptoms can be treated with oral ACE inhibitors (captopril) and Lasix. Digoxin can also be used if symptoms of heart failure are present.

Inpatient & Outpatient Medications

Complications

  • In patients with mechanical prostheses, too much warfarin may result in excessive bleeding, whereas insufficient anticoagulation may lead to thromboembolism.

Patient Education

  • Asymptomatic children with mitral regurgitation (MR) require regular examinations because the indolent course of mitral regurgitation may be deceptive as long as the heart is able to compensate for the altered hemodynamics. Patients and families require education regarding specific medications, especially warfarin.
  • For excellent patient education resources, visit eMedicine's Heart Center. Also, see eMedicine's patient education article Mitral Valve Prolapse.

Miscellaneous

Medicolegal Pitfalls

  • Pay attention to all murmurs, and differentiate benign systolic (Still) murmurs from pathologic murmurs.
 


More on Mitral Valve Insufficiency

Overview: Mitral Valve Insufficiency
Differential Diagnoses & Workup: Mitral Valve Insufficiency
Treatment & Medication: Mitral Valve Insufficiency
Follow-up: Mitral Valve Insufficiency
Multimedia: Mitral Valve Insufficiency
References
Further Reading
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References

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Keywords

mitral valve insufficiency, mitral valve regurgitation, mitral regurgitation, MR, heart defect, congenital heart defect, heart failure, systemic lupus erythematosus, SLE, cardiomyopathy, treatment, diagnosis

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Contributor Information and Disclosures

Author

Monesha Gupta-Malhotra, MD, MBBS, FAAP, FACC, FASE, Assistant Professor, Division of Pediatric Cardiology, University of Texas Medical School, Children's Memorial Hermann Hospital
Monesha Gupta-Malhotra, MD, MBBS, FAAP, FACC, FASE is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Society of Echocardiography, Medical Council of India, Society for Pediatric Research, and Society of Pediatric Echocardiography
Disclosure: Nothing to disclose.

Medical Editor

Ira H Gessner, MD, Professor Emeritus, Pediatric Cardiology
Ira H Gessner, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Pediatric Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Julian M Stewart, MD, PhD, Associate Chairman of Pediatrics, Director, Center for Hypotension, Westchester Medical Center; Professor of Pediatrics and Physiology, New York Medical College
Julian M Stewart, MD, PhD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

CME Editor

Gilbert Z Herzberg, MD, Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College; Consulting Staff, Department of Pediatrics, Sound Shore Medical Center
Gilbert Z Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Chief Editor

Stuart Berger, MD, Professor of Pediatrics, Division of Cardiology, Medical College of Wisconsin; Chief of Pediatric Cardiology, Medical Director of Pediatric Heart Transplant Program, Medical Director of The Heart Center, Children's Hospital of Wisconsin
Stuart Berger, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American College of Chest Physicians, American Heart Association, and Society for Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

 
 
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