Aortic Coarctation Medication

Updated: Feb 26, 2018
  • Author: Sandy N Shah, DO, MBA, FACC, FACP, FACOI; Chief Editor: Yasmine S Ali, MD, MSCI, FACC, FACP  more...
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Medication

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, angiotensin-converting enzyme 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. [24]

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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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