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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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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Porcine Model of Infrarenal Abdominal Aortic Aneurysm
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[Multiple aortic aneurysms in chronic atrophic polychondritis].

G Monsel1, E Maubec, C Picard-Dahan

  • 1Service de Dermatologie, AP-HP, Groupe Hospitalier Bichat Claude Bernard, Université Paris 7 Denis-Diderot, Paris.

Annales De Dermatologie Et De Venereologie
|July 28, 2007
PubMed
Summary

Chronic relapsing polychondritis can cause silent aortic aneurysms that progress despite treatment. Surgical intervention is crucial for managing these vascular lesions when they advance.

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Area of Science:

  • Rheumatology
  • Cardiovascular Medicine
  • Medical Case Reports

Background:

  • Chronic relapsing polychondritis (CRP) is a rare multisystemic inflammatory disease.
  • Cardiovascular involvement is a significant cause of mortality in CRP, second only to tracheobronchial chondritis.
  • Valvulopathy and aortic aneurysms are the most prevalent cardiovascular complications associated with CRP.

Observation:

  • A case of CRP presented with multiple, clinically silent aortic aneurysms.
  • These aortic aneurysms demonstrated progression despite treatment with systemic corticosteroids and immunosuppressive therapy.
  • Extravascular disease activity did not correlate with the progression of aortic aneurysms.

Findings:

  • Aortic aneurysms in CRP can progress independently of other disease manifestations, even when the condition appears to be in remission.
  • Medical management, including corticosteroids and immunosuppressants, showed limited efficacy in halting aneurysm progression.
  • Vascular lesions in CRP may follow a distinct, progressive course unresponsive to standard therapies.

Implications:

  • The findings underscore the need for vigilant monitoring of cardiovascular structures in patients with CRP, irrespective of apparent disease activity.
  • Early surgical consideration is paramount for managing progressive aortic aneurysms in CRP to prevent catastrophic events.
  • This case highlights the limitations of current medical therapies in controlling vascular complications of CRP, emphasizing the importance of timely surgical intervention.