If a child does not meet the criteria for the Marfan syndrome, but does have aortic enlargement, beta blockers, exercise restriction and a follow up echocardiogram are usually precsribed. If a child doesn't have the Marfan syndrome or aortic enlargement, but does have some other features that suggest the Marfan syndrome, medication is not necessary. However, it is important to have follow up echocardiograms until the end of growth to ensure that aortic enlargement doesn't develop. Very few aortic dissections or ruptures occur in childhood. Some physicians choose to start children on beta-blockers at the time of diagnosis and others wait until aortic enlargement first becomes evident.
Infants are often prescribed propanalol because it is available in a liquid form.
The amount of beta-blocker prescribed should be individualized depending on the child's response to the medication. Enough should be prescribed to achieve the desired effect on the heart rate. Most children do not experience any problems in school as a result of the medication. Beta-blockers should not be used for children with severe asthma or reactive airway disease. Instead, a calcium channel blocker, such as verapamil, can be used to lower the heart rate.