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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

279
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...
279
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

295
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...
295
Myocarditis I: Introduction01:21

Myocarditis I: Introduction

232
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
232
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

170
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...
170
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

166
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...
166
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

312
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...
312

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Myocardial Involvement in Rheumatic Disorders.

George Markousis-Mavrogenis1, Alessia Pepe2, Luna Gargani3

  • 1Onassis Cardiac Surgery Center, 50 Esperou Street, 175-61, P. Faliro, Athens, Greece.

Current Heart Failure Reports
|August 20, 2020
PubMed
Summary

Cardiovascular magnetic resonance (CMR) is crucial for evaluating heart conditions in autoimmune rheumatic diseases (ARDs). It detects inflammation and fibrosis missed by other methods, aiding early diagnosis and treatment.

Keywords:
Cardiovascular computed tomographyCardiovascular magnetic resonanceCoronary artery diseaseEchocardiographyMyocardial perfusion-fibrosisMyocarditisNuclear imagingRheumatic cardiovascular diseaseVasculitis

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Area of Science:

  • Rheumatology
  • Cardiology
  • Medical Imaging

Background:

  • Autoimmune rheumatic diseases (ARDs) affect 8% of the population, predominantly women.
  • ARDs are linked to increased cardiovascular disease (CVD) risk, involving atherosclerosis, inflammation, and fibrosis.
  • Traditional risk factors do not fully explain the excess CVD comorbidity in ARDs.

Purpose of the Study:

  • To review the role of cardiac involvement in ARDs.
  • To highlight the utility of cardiovascular magnetic resonance (CMR) in diagnosing cardiac manifestations of ARDs.
  • To provide recommendations for CMR application in ARD patients.

Main Methods:

  • Review of existing literature and clinical experience.
  • Focus on cardiovascular magnetic resonance (CMR) capabilities.
  • Evaluation of myocardial inflammation, edema, fibrosis, and atherosclerosis.

Main Results:

  • CMR can simultaneously assess cardiac function and characterize myocardial tissue (edema, fibrosis).
  • CMR's high resolution identifies early-stage myocardial inflammation, vasculitis, and fibrosis often missed by other modalities.
  • CMR is recommended for ARD patients with new-onset heart failure, arrhythmias, or discordant symptoms/evaluation.

Conclusions:

  • Chronic inflammation in ARDs accelerates atherosclerosis and promotes myocardial fibrosis.
  • CMR is the ideal imaging modality for evaluating cardiac involvement in ARDs.
  • Guidelines for CMR in ARDs are needed, but current evidence supports its use in specific clinical scenarios.