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Rheumatic Heart Disease I: Introduction

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...

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Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...

Rheumatic Heart Disease III: Medical Management

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...

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Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Pregnancy and rheumatic diseases.

M Gayed¹, C Gordon

¹Department of Rheumatology, Division of Immunity and Infection (East Wing), The Medical School University of Birmingham, Birmingham B15 2TT, UK. p.c.gordon@bham.ac.uk

Rheumatology (Oxford, England)

|July 12, 2007

Summary

Pregnancy in women with rheumatic diseases requires careful management. While many rheumatic conditions remain stable during pregnancy with appropriate therapy, postpartum flares are common, necessitating ongoing monitoring.

Area of Science:

Rheumatology
Obstetrics
Reproductive Medicine

Background:

Pregnancy in women of reproductive age with rheumatic diseases presents unique challenges.
Infertility is uncommon and often linked to cyclophosphamide treatment rather than the disease itself.

Purpose of the Study:

To discuss the implications of pregnancy for patients with rheumatic diseases.
To highlight management strategies and potential complications during pregnancy and postpartum.

Main Methods:

Review of existing literature and clinical considerations for managing rheumatic diseases during pregnancy.
Distinguishing between disease flares and conditions like pre-eclampsia.

Main Results:

Well-controlled rheumatic diseases generally do not worsen during pregnancy with continued disease-modifying therapy.

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Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Some patients with inflammatory arthritis experience remission during pregnancy.

Renal involvement increases the risk of disease flare, which must be differentiated from pre-eclampsia.

Active systemic disease, hypertension, thrombosis history, and renal involvement are associated with intrauterine growth restriction.

Premature delivery may be necessary to mitigate stillbirth risks, with potential neonatal complications.

Postpartum flares are frequent across all rheumatic diseases.

Conclusions:

Careful preconception counseling and ongoing management are crucial for pregnant patients with rheumatic diseases.
Monitoring for disease activity, pre-eclampsia, and postpartum flares is essential for optimal maternal and fetal outcomes.