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Chronic Valvular Disease PDF Print E-mail
  1. Valves between chambers of the heart allow forward movement of blood flow during contractions, and inhibit backward flow.
  2. Valves that do not close properly allow blood to leak backward during contractions causing turbulence that is heard as a murmur.
  3. With time, backward leakage may lead to dilation of the heart as it deals with an increased amount of blood being left behind after each contraction.
  4. The heart may try to compensate for the decreasing amount of blood being moved forward by pumping faster.
  5.  If the heart beats too fast, there is not adequate time for filling of the chambers between contractions, and less blood is pumped forward.
  6. Congestive heart failure develops as back-pressure in the blood vessels of the lungs causes fluid to leak out of these vessels into the lungs.
  7. The most common clinical signs of congestive heart failure include: 
  • Exercise intolerance
  • Increased respiratory rate and effort
  • Coughing

Treatment:


   1. Lasix (furosemide)

          o Lasix is a diuretic and will cause increased drinking and urination.
          o The goal of Lasix therapy is to decrease excess fluid in the body to prevent its build-up in the lungs.
          o At higher doses, or with decreased water consumption, Lasix may cause dehydration and electrolyte imbalances.

   1. Enalapril (Enacard)

          o Enalapril lowers blood pressure to decrease the resistance the heart is pumping against.

   1. Digoxin

          o Digoxin slows the heart rate to allow adequate filling between contractions and also improves cardiac contractility.
          o Narrow therapeutic range. Blood levels need to be monitored regularly to avoid toxicity.