Vasodilators for Mitral Valve Regurgitation
Angiotensin-converting enzyme (ACE) inhibitors
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Nitrates (used in acute MR)
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How It Works
Vasodilators work on different substances in the body to help widen (dilate) blood vessels.
These medicines might help mitral valve regurgitation because the wider blood vessel reduces resistance in blood flow and makes it easier for blood to move forward from the left atrium to the left ventricle to the aorta. This helps reduce the amount of blood that leaks backward through the valve into the left atrium.
Why It Is Used
Vasodilators are used to treat acute mitral valve regurgitation in the hospital. For chronic regurgitation, they might be used if you have symptoms or high blood pressure, or if your heart is not pumping blood as well as normal.
How Well It Works
Vasodilators can reduce the severity of mitral valve regurgitation when the left ventricle is not working as well as normal. 1
All medicines have side effects. But many people don’t feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Irregular heartbeats (this could be caused by too much potassium in your blood).
- Dizziness or light-headedness or fainting.
Common side effects of this medicine include:
- Dry cough.
Nitroprusside is generally only used for acute mitral regurgitation in the hospital. If nitroprusside is used, you are closely watched, because this medicine may cause severe low blood pressure.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
A cough is one of the most common side effects of ACE inhibitors. But most people do not get a cough. The cough tends to be a minor problem for most people who have it. They feel that they can live with it in exchange for the benefits of this medicine.
If you take an ACE inhibitor and have a problem with coughing, talk with your doctor. Your cough may be caused by something else, like a cold. Do not stop taking your medicine unless your doctor tells you to.
If you have a cough that is a problem for you, then your doctor might give you an angiotensin II receptor blocker (ARB) instead. ARBs are less likely to cause a cough.
Interactions with other medicines
ACE inhibitors may interact with other medicines such as non-steroidal anti-inflammatory drugs (NSAIDs), antacids, potassium supplements, certain diuretics, and lithium. If you are taking one of these medicines, talk with your doctor before you take an ACE inhibitor.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don’t take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Do not use ACE inhibitors if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.
If you take an ACE inhibitor, your doctor may check your potassium levels and how your kidneys are working to make sure this medicine is not causing problems.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
- Bonow RO, et al. (2008). 2008 Focused update incorporated into the ACC/AHA 2006 Guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to revise the 1998 Guidelines for the management of patients with valvular heart disease). Circulation, 118(15): e523–e661.
Last Revised: August 21, 2013
Author: Healthwise Staff
Medical Review: Rakesh K. Pai, MD, FACC – Cardiology, Electrophysiology & Brian D. O’Brien, MD – Internal Medicine & John A. McPherson, MD, FACC, FSCAI – Cardiology