Table 2.

Summary of useful medical treatments in valvar heart disease

Lesion	Symptom control	Secondary prevention and natural history
Aortic stenosis	Diuretics for heart failure. Nitrates and β blockers for angina	No proven treatment but lipid lowering therapy may slow progression of calcific aortic stenosis
Mitral stenosis	Diuretics for heart failure. Digoxin, β blockers, and rate limiting calcium antagonists for rate control in atrial fibrillation	Penicillin prophylaxis against recurrent episodes of rheumatic fever. Anticoagulants to prevent systemic thromboembolism
Aortic regurgitation	Diuretics and vasodilators (usually ACE inhibitors) for heart failure	Vasodilators (nifedipine or ACE inhibitors) to protect the left ventricular myocardium and delay the need for surgery
Mitral regurgitation	Diuretics and vasodilators (usually ACE inhibitors) for heart failure	No proven treatment

ACE, angiotensin converting enzyme.