Treatment of Rheumatic Heart Disease with Moderate to Severe Mitral Regurgitation

Rheumatic heart disease presenting with moderate to severe mitral regurgitation requires targeted symptomatic medical management. The degree of valve dysfunction in this setting drives a specific, evidence-based pharmacological approach.

Clinical Scenario

Moderate to Severe Mitral Regurgitation

This protocol addresses patients with rheumatic heart disease in whom significant mitral regurgitation — moderate to severe in degree — is the defining haemodynamic feature. The presence and severity of this valvular finding shape the selection of medical therapy.

Treatment Approach (partial overview)

Symptomatic management in this setting involves a combination of agents directed at fluid balance and afterload reduction. Specific classes of medication are selected to address both volume overload and the haemodynamic burden imposed by the regurgitant valve.

The complete regimen — including agent selection, sequencing, and monitoring targets — is in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1161/CIR.0000000000000921

Symptomatic medical management of moderate to severe MR includes diuretic agents (loop diuretic agents and spironolactone) and afterload reduction with vasodilator therapy, most often angiotensin-converting enzyme inhibition and angiotensin II receptor blockers.

Additionally, digoxin and β-blockade may be considered.

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