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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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Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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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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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 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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Anatomy of the Heart01:27

Anatomy of the Heart

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The human heart is made up of three layers of tissue that are surrounded by the pericardium, a membrane that protects and confines the heart. The outermost layer, closest to the pericardium, is the epicardium. The pericardial cavity separates the pericardium from the epicardium. Beneath the epicardium is the myocardium, the middle layer, and the endocardium, the innermost layer. There are four chambers of the heart: the right atrium, the right ventricle, the left atrium, and the left ventricle.
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Implantation of Total Artificial Heart in Congenital Heart Disease
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Paravalvular Leak in Structural Heart Disease.

Kashish Goel1, Mackram F Eleid2

  • 1Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Current Cardiology Reports
|March 8, 2018
PubMed
Summary
This summary is machine-generated.

Diagnosing and managing paravalvular leak (PVL) is crucial due to its increasing prevalence. Percutaneous closure offers a highly successful treatment option for this growing structural heart disease concern.

Keywords:
ClosureHemolysisParavalvular leakStructuralValvular heart disease

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Paravalvular leak (PVL) is an increasing complication associated with both surgical and transcatheter heart valves.
  • Advanced imaging and high clinical suspicion are essential for accurate PVL diagnosis and management.
  • Mild PVL is common, but greater than mild PVL is linked to adverse clinical outcomes, particularly after transcatheter aortic valve replacement.

Purpose of the Study:

  • To review the escalating significance of diagnosing and managing paravalvular leaks.
  • To highlight current diagnostic and management strategies for PVL.
  • To discuss the role of percutaneous closure versus surgical repair for PVL.

Main Methods:

  • Review of recent clinical trials and studies on paravalvular leak.
  • Analysis of data on transcatheter aortic valve replacement outcomes related to PVL.
  • Evaluation of percutaneous closure techniques and outcomes for PVL.

Main Results:

  • PVL is a growing concern in structural heart disease.
  • PVL greater than mild is associated with worse clinical outcomes.
  • Percutaneous closure demonstrates a success rate exceeding 90% with significant symptom improvement and low complication rates.

Conclusions:

  • Percutaneous closure is the preferred method for PVL management when feasible.
  • Surgical repair is reserved for cases where percutaneous closure is contraindicated or unsuccessful.
  • Effective PVL management is critical for improving patient outcomes in structural heart disease.