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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 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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Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
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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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Polymyalgia Rheumatica.

Miriam Giovanna Colombo1, Anna-Jasmin Wetzel, Hannah Haumann

  • 1Institute for General Practice and Inter - professional Care, University Hospital Tübingen; Department of Analytics and Data Science, AOK Baden-Württemberg, Stuttgart; Medical Division, AOK Baden-Württemberg, Stuttgart.

Deutsches Arzteblatt International
|May 31, 2022
PubMed
Summary
This summary is machine-generated.

Polymyalgia rheumatica (PMR) affects older adults, with higher incidence in women. While treatable with glucocorticoids, many patients experience symptom recurrence, highlighting the need for further research into risk factors and non-pharmacological treatments.

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Area of Science:

  • Rheumatology
  • Epidemiology
  • Geriatrics

Background:

  • Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease in older adults.
  • Known risk factors include female sex, prior infections, and genetics.
  • No prior epidemiological data for PMR in Germany was available.

Purpose of the Study:

  • To determine the incidence and prevalence of PMR in Germany.
  • To analyze diagnostic patterns and treatment responses.
  • To identify needs for further research.

Main Methods:

  • Literature search of PubMed publications.
  • Analysis of administrative health insurance data (2011-2019) for individuals aged 40+.
  • Quantification of physician consultations for PMR diagnosis.

Main Results:

  • Annual age- and sex-standardized incidence: 18.6/100,000; prevalence: 138.8/100,000.
  • Higher incidence in women (21.8/100,000) vs. men (12.8/100,000).
  • 60% of diagnoses occurred in primary care; 43% of patients had recurrent symptoms within a year.

Conclusions:

  • PMR is manageable in primary care, but patients are often multimorbid and require frequent follow-up.
  • Glucocorticoid treatment is effective but requires dose adjustments due to recurrence.
  • Further research is needed on etiology, chronic course risk factors, and non-pharmacological interventions.