Pediatric Mitral Valve Prolapse Medication

Updated: Mar 21, 2017
  • Author: Poothirikovil Venugopalan, MBBS, MD, FRCPCH; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Medication

Medication Summary

Medical strategies for mitral valve prolapse (MVP) include the following:

  • Anticongestive heart failure therapy

  • Antibiotic therapy for endocarditis prophylaxis during surgery, dental, and genitourinary procedures: Only necessary if associated mitral regurgitation is present (See Antibiotic Prophylactic Regimens for Endocarditis.) [18]

  • Antiarrhythmic therapy: May be indicated in patients with documented and/or symptomatic arrhythmia, depending on findings of noninvasive and/or invasive electrophysiologic testing

  • Beta-blockers (eg, propranolol): May be beneficial for symptom prevention, reduction in ectopy, treatment of vasodepressor syncope, panic attacks, or antiarrhythmic therapy [25]

  • Antiplatelet therapy (eg, aspirin, dipyridamole): Used in patients with thromboembolic episodes

  • Angiotensin-converting enzymne (ACE) inhibitors:- Used in patients with significant mitral regurgitation

  • Low-dose aspirin and/or anticoagulant therapy (eg, warfarin): Considered in patients with thromboembolic episodes

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Beta-adrenergic blocking agents

Class Summary

These agents block the beta-adrenergic receptor and are modulators of the autonomic system. They inhibit chronotropic, inotropic and vasodilatory responses to beta-adrenergic stimulation.

Propranolol (Inderal)

Inhibits beta1-adrenergic and beta2-adrenergic receptors. Class II antiarrhythmic, nonselective, beta-adrenergic receptor blocker with membrane-stabilizing activity that decreases automaticity of contractions.

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Antiplatelet agents

Class Summary

These drugs are used for secondary prevention of thrombotic cerebrovascular or cardiac disease.

Aspirin (Anacin, Bayer, Empirin)

Inhibits prostaglandin synthesis, which prevents formation of platelet-aggregating thromboxane A2.

Dipyridamole (Persantine)

Acts by decreasing platelet aggregation. Inhibits thrombus formation in the arterial side of circulation.

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Diuretics

Class Summary

These drugs are used to release retained fluid and lower preload.

Furosemide (Lasix)

Inhibits reabsorption of fluid from ascending limb of the Henle loop in renal tubule. Administered IV. Has venodilation action; thus, also lowers preload even before diuresis effect. Useful in acute heart failure and exacerbations of chronic heart failure.

Spironolactone (Aldactone)

Potassium-sparing diuretic. Acts on the distal convoluted tubule of the kidney as an aldosterone antagonist. Has synergistic action with furosemide.

Amiloride (Midamor)

Pyrazine-carbonyl-guanidine unrelated chemically to other known antikaliuretic or diuretic agents. Potassium-conserving (antikaliuretic) drug that, compared with thiazide diuretics, possesses weak natriuretic, diuretic, and antihypertensive activity. Acts directly on the distal renal tubule, usually used along with a potassium-losing diuretic.

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ACE inhibitors

Class Summary

These agents reduce afterload and decrease myocardial remodeling, which worsens chronic heart failure.

Captopril (Capoten)

Accepted as essential part of heart failure therapy. Not only gives symptomatic improvement but also prolongs survival.

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Cardiac glycoside

Class Summary

These agents provide symptomatic improvement in heart failure.

Digoxin (Lanoxin)

Improves myocardial contractility, reduces heart rate, and lowers sympathetic stimulation in chronic heart failure.

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