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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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Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

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Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
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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 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

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...
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Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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A Pilot Study: Hypertension, Endothelial Dysfunction and Retinal Microvasculature in Rheumatic Autoimmune Diseases.

Ahmed Mahdy1, Martin Stradner2, Andreas Roessler1

  • 1Physiology Division, Otto Loewi Center of Research in Vascular Biology, Immunity and Inflammation, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria.

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Autoimmune rheumatic diseases like rheumatoid arthritis and Sjögren syndrome show high hypertension rates and signs of endothelial dysfunction. Close monitoring for cardiovascular disease risk factors is crucial in these patients.

Keywords:
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Area of Science:

  • Rheumatology
  • Cardiology
  • Vascular Biology

Background:

  • Autoimmune rheumatic diseases (ARDs) have unknown etiology but are linked to endothelial dysfunction and premature atherosclerosis.
  • Atherosclerosis is a primary cause of cardiovascular diseases (CVDs), with hypertension being a major traditional risk factor.
  • This study investigates the link between ARDs and cardiovascular risk.

Purpose of the Study:

  • To assess cardiovascular risk factors in patients with rheumatoid arthritis (RA) and primary Sjögren syndrome (PSS).
  • To compare blood pressure, arterial stiffness, and endothelial markers between ARD patients and healthy controls.

Main Methods:

  • A case-control study involving 10 RA patients, 10 PSS patients, and 10 healthy controls.
  • Measurements included mean blood pressure (MBP), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse wave velocity (PWV), and plasma asymmetric dimethylarginine (ADMA).
  • Retinal microvasculature was analyzed from retinal photographs; statistical analyses included t-tests and ANOVA.

Main Results:

  • Hypertension prevalence was high in RA (80%) and PSS (40%) compared to controls (20%).
  • Significant increases in MBP, SBP, and DBP were observed in RA patients compared to controls.
  • Elevated plasma ADMA levels were found in RA patients compared to controls, indicating endothelial dysfunction.

Conclusions:

  • Autoimmune rheumatic diseases exhibit a high prevalence of hypertension and endothelial dysfunction.
  • These conditions are significant risk factors for cardiovascular diseases.
  • Regular monitoring of hypertension and endothelial dysfunction is recommended for patients with ARDs to mitigate CVD risk.