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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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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 Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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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...
1.0K
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

490
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...
490
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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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...
450
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

798
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

1.3K
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding
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Update on rheumatic heart disease.

Bobby Yanagawa1, Jagdish Butany, Subodh Verma

  • 1aDivision of Cardiac Surgery, St Michael's Hospital bDivision of Pathology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.

Current Opinion in Cardiology
|January 6, 2016
PubMed
Summary
This summary is machine-generated.

Rheumatic heart disease (RHD) pathogenesis remains complex, with autoimmunity and innate immunity implicated. Current management relies on antibiotics, but mitral valve repair shows promising surgical outcomes.

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Area of Science:

  • Cardiology
  • Immunology
  • Rheumatology

Background:

  • Rheumatic heart disease (RHD) is a significant global health concern, primarily affecting young individuals in low-resource settings.
  • Its pathogenesis involves a complex interplay of autoimmune responses triggered by streptococcal infections.
  • Understanding the evolving mechanisms is crucial for effective prevention and treatment strategies.

Purpose of the Study:

  • To provide a comprehensive overview of the current knowledge regarding the pathogenesis, diagnosis, and management of RHD.
  • To highlight recent advancements and ongoing research in the field.
  • To identify areas requiring further investigation.

Main Methods:

  • Review of current literature on RHD pathogenesis, focusing on molecular mimicry and autoimmune targets.
  • Analysis of diagnostic criteria, including the role of echocardiography in identifying subclinical carditis.
  • Evaluation of therapeutic strategies, encompassing antibiotic prophylaxis, anti-inflammatory agents, and surgical interventions.

Main Results:

  • Pathogenesis research increasingly points to nonsarcomeric autoantigens, endothelial injury, and innate immunity, beyond initial autoimmunity theories.
  • The 2015 revised Jones Criteria emphasize echocardiography for diagnosing acute rheumatic fever and subclinical carditis.
  • Lifelong antibiotics remain the cornerstone of medical management; targeted anti-inflammatory therapies have shown limited success.
  • Percutaneous mitral balloon valvuloplasty shows potential for improving patient selection and outcomes.
  • Surgical management favors valve repair over replacement, with excellent operative and midterm results reported in expert centers.

Conclusions:

  • Significant gaps in understanding RHD pathogenesis persist.
  • Long-term antibiotic therapy is the sole established medical treatment.
  • Advances in mitral valve repair techniques offer durable solutions, particularly in high-volume, specialized centers.