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Related Concept Videos

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

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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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Issues And Trends In Healthcare Delivery System01:29

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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
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Rheumatic Heart Disease IV: Nursing Management01:20

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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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Rheumatic Heart Disease I: Introduction01:23

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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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Related Experiment Video

Updated: Mar 18, 2026

A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
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Telerheumatology: A technology appropriate for virtually all.

Zsolt Kulcsar1, Daniel Albert1, Ellyn Ercolano2

  • 1Geisel School of Medicine at Dartmouth, Hanover, NH; Rheumatology Department, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Seminars in Arthritis and Rheumatism
|July 11, 2016
PubMed
Summary

Telerheumatology successfully expanded specialty care access in rural New Hampshire and Vermont, showing high patient and provider satisfaction. Future efforts should focus on patient selection to optimize telerheumatology effectiveness.

Keywords:
Patient satisfactionQuality improvement;Rural healthTelehealthTelemedicineTelerheumatologyVideo consultation

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Area of Science:

  • Medical Informatics
  • Rheumatology
  • Telehealth

Background:

  • Rural populations in New Hampshire (NH) and Vermont (VT) face limited access to specialized healthcare due to geographic isolation.
  • Dartmouth-Hitchcock Medical Center (DHMC) established telerheumatology services to address these access barriers.

Purpose of the Study:

  • To evaluate the challenges and successes of an early telerheumatology program.
  • To assess patient and provider satisfaction with telerheumatology services.

Main Methods:

  • Retrospective review of patients seen in telerheumatology from October 2011 to December 2014.
  • Patient and provider interviews to gather qualitative feedback on their experience.
  • Assessment of patient and provider satisfaction levels.

Main Results:

  • 176 patients completed 244 telerheumatology visits between October 2011 and December 2014.
  • Inflammatory arthritis was the most common diagnosis (63.9%).
  • 19% of patients were deemed inappropriate for telerheumatology due to unclear diagnosis or disease complexity.

Conclusions:

  • Telerheumatology effectively increased access to rheumatology specialty care in rural NH and VT.
  • High patient and provider satisfaction was observed.
  • A need for improved patient selection and a potential triage mechanism was identified to enhance program efficiency.