Treatments for Heart conditions

• Atrial flutter
  –Rate control is initial goal of therapy
  –Anticoagulation is controversial
  –Cardioversion to terminate rhythm
  –Radiofrequency ablation may be curative

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Murmurs - Diastolic: Treatment
(In a Page: Signs and Symptoms)

• Attention to hemodynamic status
• Treat the underlying cause (e.g., anemia, infection, hyperthyroidism, MI)
• Serial examinations to track progression of underlying cause
• Valve repair or replacement may be indicated for severe valvular disease

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Murmurs - Systolic: Treatment
(In a Page: Signs and Symptoms)

• Attention to hemodynamic status
• Treat the underlying cause (e.g., anemia, infection, hyperthyroidism, MI)
• Serial examinations to track progression of underlying cause
• Valve repair/replacement may be indicated for severe valvular disease

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Abnormal Heart Sounds: Treatment
(In A Page: Pediatric Signs and Symptoms)

• Innocent murmurs
  –Parental reassurance that this is a normal, common finding in children representing normal blood flowing through a normal heart, usually disappearing with age (as the patient grows, the stethoscope is farther from the heart, so the sound isn’t heard)
  –The murmur may get louder during times of increased cardiac output (i.e., illness, fever, dehydration, activity, or other stress)
  –No bacterial endocarditis prophylaxis required

• Abnormal findings requiring referral
  –Abnormal S2 (single or widely split)
  –Holosystolic/regurgitant murmur
  –Any diastolic sounds
  –Systolic ejection clicks: “Harsh” murmurs
  –Any murmur with cardiac symptoms
• Further treatment is dependent on underlying anatomy and physiology

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Heart Failure: Treatment
(In A Page: Pediatric Signs and Symptoms)

• Increased afterload due to left-sided obstructive lesion
  –Use prostaglandins to open ductus arteriosus to relieve the obstruction, and/or use the right ventricle for systemic circulatory support
  –Inotropic support (dopamine/dobutamine) if very ill
  –Surgical intervention depending on specific anatomy

• Left-to-right shunt lesions
  –Diuretics to decrease lung fluid and improve respiratory mechanics
  –Inotropic support with dopamine/dobutamine for critically ill, digoxin for chronic use
  –Systemic afterload reduction with ACE inhibitors if systemic BP adequate
• Myocardial disease
  –Diuretics and inotropes for afterload reduction
  –β-blockers and ACE inhibitors
  –Mechanical circulatory support and cardiac transplantation for advanced heart failure

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Pulse rhythm abnormality: Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))

Quickly look for signs of reduced cardiac output, such as a decreased level of consciousness (LOC), hypotension, or dizziness. Promptly obtain an electrocardiogram (ECG) and possibly a chest X-ray, and begin cardiac monitoring. Insert an I.V. line for administration of emergency cardiac drugs, and give oxygen by nasal cannula or mask. Closely monitor the patient’s vital signs, pulse quality, and cardiac rhythm because accompanying bradycardia or tachycardia may result in poor tolerance of the abnormal rhythm and cause further deterioration of cardiac output. Keep emergency intubation, cardioversion, defibrillation, and suction equipment handy.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Valvular heart disease: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment depends on the nature and severity of associated symptoms. For example, heart failure requires digoxin, diuretics, a sodium-restricted diet and, in acute cases, oxygen. Other measures may include anticoagulant therapy or antiplatelet medications to prevent thrombus formation around diseased or replaced valves, prophylactic antibiotics before and after surgery or dental care, and valvuloplasty. An intra-aortic balloon pump may be used temporarily to reduce backflow by enhancing forward blood flow into the aorta.

If the patient has severe signs and symptoms that can’t be managed medically, open heart surgery using cardiopulmonary bypass for valve replacement is indicated.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Cardiac arrest, ventricular fibrillation: Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))

CPR, fluids, epinephrine, vasopressin, oxygen, mechanical ventilation, defibrillation, amiodarone, procainamide

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Cardiac tamponade: Treatment
(Professional Guide to Diseases (Eighth Edition))

The goal of treatment is to relieve intrapericardial pressure and cardiac compression by removing accumulated blood or fluid. Pericardiocentesis (needle aspiration of the pericardial cavity) or surgical creation of an opening (pericardiectomy or pericardial window) dramatically improves systemic arterial pressure and cardiac output with aspiration of as little as 25 ml of fluid. Such treatment necessitates continuous hemodynamic and ECG monitoring in the intensive care unit. Trial volume loading with temporary I.V. normal saline solution with albumin, and perhaps an inotropic drug, such as isoproterenol or dopamine, is necessary in the hypotensive patient to maintain cardiac output. Although these drugs normally improve myocardial function, they may further compromise an ischemic myocardium after MI.

Depending on the cause of tamponade, additional treatment may include:

❑ in traumatic injury — blood transfusion or a thoracotomy to drain reaccumulating fluid or to repair bleeding sites

❑ in heparin-induced tamponade — the heparin antagonist protamine sulfate

❑ in warfarin-induced tamponade — vitamin K.

Resection of a portion or all of the pericardium to allow full communication with the pleura may be needed if repeated pericardiocentesis fails to prevent recurrence.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Heart failure: Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))

Diuresis, digoxin, vasodilators, inotropics, angiotensin-converting enzyme inhibitors, oxygen

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Rheumatic fever and rheumatic heart disease: Treatment
(Professional Guide to Diseases (Eighth Edition))

Effective management eradicates the streptococcal infection, relieves symptoms, and prevents recurrence, reducing the chance of permanent cardiac damage. During the acute phase, treatment includes penicillin, sulfadiazine, or erythromycin. Salicylates such as aspirin relieve fever and minimize joint swelling and pain; if carditis is present or salicylates fail to relieve pain and inflammation, corticosteroids may be used. Supportive treatment requires strict bed rest for about 5 weeks during the acute phase with active carditis, followed by a progressive increase in physical activity, depending on clinical and laboratory findings and the response to treatment.

After the acute phase subsides, low-dose antibiotics may be used to prevent recurrence. Such preventive treatment usually continues for 5 years or until age 21 (whichever is longer). Heart failure necessitates continued bed rest and diuretics. Severe mitral or aortic valve dysfunction that causes persistent heart failure requires corrective valvular surgery, including commissurotomy (separation of the adherent, thickened leaflets of the mitral valve), valvuloplasty (inflation of a balloon within a valve), or valve replacement (with prosthetic valve). Such surgery is seldom necessary before late adolescence.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Murmurs: Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))

Instruct the patient to contact his physician before undergoing invasive procedures or dental work because prophylactic antibiotics may be necessary.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Pulse rhythm abnormality: Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))

Quickly look for signs of reduced cardiac output, such as decreased level of consciousness (LOC), hypotension, or dizziness. Promptly obtain an electrocardiogram (ECG) and possibly a chest X-ray, and begin cardiac monitoring. Insert an I.V. line for administration of emergency cardiac drugs, and give oxygen by nasal cannula or mask. Closely monitor vital signs, pulse quality, and cardiac rhythm because accompanying bradycardia or tachycardia may result in poor tolerance of the abnormal rhythm and cause further deterioration of cardiac output. Keep emergency intubation, cardioversion, and suction equipment handy.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Valvular heart disease: Treatment
(Handbook of Diseases)

Therapy depends on the nature and severity of associated symptoms. For example, heart failure requires digoxin, diuretics, a sodium-restricted diet and, in acute cases, oxygen.

Other measures may include anticoagulant therapy to prevent thrombus formation around diseased or replaced valves, prophylactic antibiotics before and after surgery or dental care, and valvuloplasty. If the patient has severe signs and symptoms that can’t be managed medically, open-heart surgery using cardiopulmonary bypass for valve replacement is indicated.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Cardiac tamponade: Treatment
(Handbook of Diseases)

The goal of treatment is to relieve intrapericardial pressure and cardiac compression by removing accumulated blood or fluid. Pericardiocentesis (needle aspiration of the pericardial cavity) or surgical creation of an opening dramatically improves systemic arterial pressure and cardiac output with aspiration of as little as 25 ml of fluid. Such treatment necessitates continuous hemodynamic and ECG monitoring in the intensive care unit.

If tamponade or effusions or adhesions from chronic pericarditis recur, a portion or all of the pericardium may need to be removed to allow adequate ventricular filling and contraction. A pericardial window may be performed, which involves removing a portion of the pericardium to permit excess pericardial fluid to drain into the pleural space. In more severe cases, removal of the toughened encasing pericardium (pericardectomy) may be necessary.

If the patient is hypotensive, trial volume loading with temporary I.V. normal saline solution with albumin and perhaps an inotropic drug, such as isoproterenol or dopamine, is necessary to maintain cardiac output.

Clinical tip  Although inotropic drugs normally improve myocardial function, they may further compromise an ischemic myocardium after an MI.

Depending on the cause of tamponade, additional treatment may include:

❑ for traumatic injury: blood transfusion or a thoracotomy to drain reaccumulating fluid or to repair bleeding sites

❑ for heparin-induced tamponade: the heparin antagonist protamine sulfate

❑ for warfarin-induced tamponade: vitamin K.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Heart failure: Treatment
(Handbook of Diseases)

The aim of therapy is to improve pump function by reversing the compensatory mechanisms that are producing the symptoms. Heart failure can be controlled by treatment consisting of:

❑ diuresis to reduce total blood volume and circulatory congestion; spironolactone, a potassium-sparing diuretic, and nesiritide, a recombinant form of human BNP, are helpful

❑ vasodilators and angiotensin-converting enzyme inhibitors to increase cardiac output by reducing the impedance to ventricular outflow (afterload)

❑ digoxin to strengthen myocardial contractility

❑ beta-adrenergic blockers to improve ejection fraction and reduce morbidity and mortality

❑ dietary restrictions, such as restricted sodium and limiting fluid intake to 2 L/day

❑ biventricular pacemaker to control ventricular dyssynchrony

❑ antiembolism stockings to prevent venostasis and thromboembolus.

UNDER STUDY: An innovative approach to heart failure that remains under investigation is cellular cardiomyoblasty, the transplantation of autologous ex-vivo expanded cells into the myocardium. The transplanted muscle cells promote heart muscle regeneration.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Rheumatic fever and rheumatic heart disease: Treatment
(Handbook of Diseases)

Effective management eradicates the streptococcal infection, relieves symptoms, and prevents recurrence, reducing the chance of permanent cardiac damage.

Treatment in acute phase

During the acute phase, treatment includes low doses of antibiotics, such as penicillin, sulfadiazine, or erythro-mycin. Salicylates, such as aspirin, can help relieve fever and minimize joint swelling and pain; if carditis is present or the salicylate fails to relieve pain and inflammation, corticosteroids may be used.

Supportive treatment requires strict bed rest for about 5 weeks during the acute phase with active carditis, followed by a progressive increase in physical activity, depending on clinical and laboratory findings and the patient’s response to treatment.

Preventive treatment

After the acute phase subsides, the patient is maintained on low-dose antibiotic therapy, especially during the first 3 to 5 years after the initial episode of rheumatic fever, to prevent recurrence. Such preventive treatment usually continues for 5 to 10 years.

Surgery and other measures

Heart failure necessitates continued bed rest and diuretic therapy. Severe mitral or aortic valvular dysfunction causing persistent heart failure requires corrective valvular surgery, including commissurotomy (separation of the adherent, thickened leaflets of the mitral valve), valvuloplasty (inflation of a balloon within a valve), or valve replacement (with a prosthetic valve). Corrective valvular surgery is rarely necessary before late adolescence.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Murmurs: Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

Prepare the patient for diagnostic tests, such as electrocardiography, echocardiography, and angiography. Administer an antibiotic and an anticoagulant as appropriate. Because any cardiac abnormality is frightening to the patient, provide emotional support.

Patient teaching

Instruct the patient to contact his physician before undergoing invasive procedures or dental work because prophylactic antibiotics may be necessary. Explain the signs and symptoms the patient should report.

» READ BOOK EXCERPT ONLINE »

Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

Pulse rhythm abnormality: Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

Be prepared to administer sedation if the patient requires cardioversion therapy. Check his vital signs frequently to detect bradycardia, tachycardia, hypertension or hypotension, tachypnea, and dyspnea. Also, monitor intake, output, and daily weight.

Collect blood samples for serum electrolyte, cardiac enzyme, and drug level studies. Prepare the patient for a chest X-ray and a 12-lead ECG. If possible, obtain a previous ECG with which to compare current findings. Prepare the patient for 24-hour Holter monitoring.

Assist the patient with ambulation, as necessary. To prevent falls and injury, raise the side rails of his bed and don’t leave him unattended while he’s sitting or walking.

If indicated, prepare the patient for transfer to a cardiac or intensive care unit.

Patient teaching

Instruct the patient to keep a diary of activities and symptoms that develop to correlate with the incidence of arrhythmias. Educate him about the importance of avoiding tobacco and caffeine, both of which increase arrhythmia. Provide information on smoking cessation programs. Discuss strategies to improve medication compliance.

Teach the patient how to take his pulse rate and advise him to notify his physician if he detects an abnormality. Explain the signs and symptoms he should report to his physician immediately as well as those necessitating immediate emergency care.

» READ BOOK EXCERPT ONLINE »

Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

Murmurs: Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Although not usually a sign of an emergency, murmurs — especially newly developed ones — may signal a serious complication in patients with bacterial endocarditis or a recent acute MI. When caring for a patient with known or suspected bacterial endocarditis, carefully auscultate for any new murmurs. Their development along with crackles, distended jugular veins, orthopnea, and dyspnea may signal heart failure.

Regular auscultation is also important in a patient who has experienced an acute MI. A loud decrescendo holosystolic murmur at the apex that radiates to the axilla and left sternal border or throughout the chest is significant, particularly in association with a widely split S₂ and an atrial gallop (S₄). This murmur, when accompanied by signs of acute pulmonary edema, usually indicates the development of acute mitral insufficiency due to rupture of the chordae tendineae — a medical emergency.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Pulse rhythm abnormality: Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Quickly look for signs of reduced cardiac output, such as decreased level of consciousness (LOC), hypotension, or dizziness. Promptly obtain an electrocardiogram (ECG) and possibly a chest X-ray, and begin cardiac monitoring. Insert an I.V. line for administration of emergency cardiac drugs, and give oxygen by nasal cannula or mask. Closely monitor vital signs, pulse quality, and cardiac rhythm because accompanying bradycardia or tachycardia may result in poor tolerance of the abnormal rhythm and cause further deterioration of cardiac output. Keep emergency intubation, cardioversion, and suction equipment handy.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Murmurs: Nursing considerations
(Nursing: Interpreting Signs and Symptoms)

▪ Prepare the patient for diagnostic tests, such as electrocardiography, echocardiography, and angiography.

▪ Administer an antibiotic and an anticoagulant as appropriate.

▪ Because a cardiac abnormality is frightening to the patient, provide emotional support.

▪ Monitor the patient's heart rhythm and vital signs.

Patient teaching

▪ Explain the use of prophylactic antibiotics.

▪ Explain signs and symptoms that require prompt medical attention.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Pulse rhythm abnormality: Nursing considerations
(Nursing: Interpreting Signs and Symptoms)

▪ Monitor cardiac rhythm and obtain a 12-lead ECG.

▪ Prepare the patient for cardioversion, if indicated .

▪ Check vital signs frequently to detect hypertension or hypotension, tachypnea, and dyspnea. Also, monitor intake, output, daily weight, and pulse oximetry.

▪ Collect blood samples for serum electrolyte, cardiac markers, complete blood count, and drug level studies. Prepare the patient for a chest X-ray.

▪ Obtain a previous ECG with which to compare current findings.

Patient teaching

▪ Explain the importance of keeping a diary of activities and any symptoms that develop to correlate with the incidence of arrhythmias.

▪ Instruct the patient to avoid tobacco and caffeine.

▪ Teach the patient how to take his pulse.

▪ Reinforce signs and symptoms that require prompt medical attention.

▪ Explain the underlying disorder and treatment plan.

▪ Teach the patient about prescribed medications, including dosage, administration, and possible adverse effects.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

 » Next page: Doctors and Medical Specialists for Heart conditions

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

• Doctors and Medical Specialists for Heart conditions
• Cure Research for Heart conditions
• Deaths from Heart conditions
• Death Statistics for Types of Heart conditions
• Medical News Summaries About Heart conditions

Tools & Services:

• Bookmark this page
• Take a survey relating to Heart conditions
• Symptom Search
• Symptom Checker
• Medical Dictionary
• Give your feedback

Medical Articles:

• Disease & Treatments Search
• Misdiagnosis Center
• Full list of interesting articles

Forums & Message Boards

• Ask or answer a question at the Boards:
• I cannot get a diagnosis. Please help.
• Tell us your medical story.
• Share your misdiagnosis story.
• What is the best treatment for my condition?
• See all the Boards.

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com