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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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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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Relapsing polychondritis associated with heart block.

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Relapsing polychondritis (RP) can cause heart block (HB). A rare case of RP with heart block was successfully treated with methylprednisolone pulse therapy, avoiding pacemaker insertion.

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Area of Science:

  • Cardiology
  • Rheumatology
  • Immunology

Background:

  • Relapsing polychondritis (RP) is a rare systemic autoimmune disease.
  • Heart block (HB) is a potential, serious complication of RP.
  • Literature review identified 10 studies on RP and HB, with limited treatment data.

Observation:

  • A case of a patient with relapsing polychondritis developed heart block.
  • The patient's heart block was successfully treated with high-dose methylprednisolone pulse therapy.
  • This treatment avoided the need for pacemaker implantation.

Findings:

  • Most reported RP-associated HB cases occurred in males aged 30-66.
  • RP was active at the time of HB onset in most patients.
  • Glucocorticoids were frequently used, and pacemakers were inserted in some cases.

Implications:

  • Glucocorticoid pulse therapy may be an effective treatment for heart block in RP patients.
  • This approach could potentially prevent pacemaker insertion in select cases.
  • Further research is warranted to confirm the efficacy of this treatment strategy.