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Related Concept Videos

Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

36
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 II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

49
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...
49

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Related Experiment Video

Updated: Sep 2, 2025

Investigating Aortic Valve Calcification via Isolation and Culture of T Lymphocytes using Feeder Cells from Irradiated Buffy Coat
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Autoimmune connective tissue diseases and aortic valve replacement outcomes: a population-based study.

Mohamed M Gad1, Devora Lichtman1, Anas M Saad1

  • 1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Heart and Vascular Institute, 9500 Euclid Avenue, J2-3, Cleveland, OH 44195, USA.

European Heart Journal Open
|August 3, 2022
PubMed
Summary

Patients with autoimmune connective tissue diseases (CTDs) undergoing aortic valve replacement (AVR) have comparable outcomes to non-CTD patients. CTD history should be considered but not prohibit AVR interventions for valvular heart disease.

Keywords:
Aortic valve replacementAutoimmune connective tissue diseasesValvular heart disease

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Area of Science:

  • Cardiology
  • Rheumatology
  • Health Services Research

Background:

  • Autoimmune connective tissue diseases (CTDs) are associated with a high burden of valvular heart disease.
  • Patients with CTDs are often perceived as high surgical risk for interventions like aortic valve replacement (AVR).

Purpose of the Study:

  • To compare the outcomes of aortic valve replacement (AVR) in patients with and without connective tissue diseases (CTDs).
  • To evaluate the impact of CTD on mortality and stroke after AVR.

Main Methods:

  • Retrospective analysis of the Nationwide Readmissions Database (2012-2018).
  • Inclusion of patients undergoing AVR, with specific CTDs identified (e.g., lupus, rheumatoid arthritis, scleroderma).
  • Exclusion of patients undergoing concomitant coronary artery bypass grafting.

Main Results:

  • A total of 569,600 hospitalizations were analyzed, with 16,531 (2.9%) having CTD.
  • CTD patients were more likely female, with higher rates of heart failure and pulmonary hypertension.
  • CTD patients exhibited lower mortality (OR 0.66) and stroke (OR 0.87) rates compared to non-CTD patients post-AVR.
  • Both surgical AVR (SAVR) and transcatheter AVR (TAVR) showed lower mortality in CTD patients; stroke outcomes were comparable for TAVR.

Conclusions:

  • Outcomes for patients with CTDs undergoing AVR are not inferior to those without CTDs.
  • A history of CTD should be considered in heart team decision-making for AVR but should not preclude intervention.
  • These findings support AVR interventions for carefully selected CTD patients with valvular heart disease.