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Related Concept Videos

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 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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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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Vascular Spasm01:16

Vascular Spasm

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The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
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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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Veins of Upper Limbs01:17

Veins of Upper Limbs

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The human circulatory system, a marvel of biological engineering, is a complex network of vessels that transport blood throughout the body. Among these, the veins responsible for carrying blood from the upper limbs are divided into two categories: deep and superficial.
The deep venous system is primarily composed of the ulnar and radial veins. The ulnar vein, which drains the fingers through the superficial palmar venous arches, and the radial vein, which serves the palms via the deep palmar...
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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
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Rheumatoid variable vessel vasculitis concurrently affecting small, medium and large vessels.

Andrew Bernard Xu1, Ian Liang1,2, Matthew Parker3,2,4

  • 1Rheumatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.

BMJ Case Reports
|July 4, 2025
PubMed
Summary
This summary is machine-generated.

Rheumatoid vasculitis (RV) can manifest before rheumatoid arthritis (RA) diagnosis. This case shows RV affecting multiple vessel sizes preceding RA, challenging early diagnosis.

Keywords:
Peripheral nerve diseaseRheumatoid arthritisVasculitis

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Area of Science:

  • Rheumatology
  • Immunology
  • Vascular Medicine

Background:

  • Rheumatoid vasculitis (RV) is a severe complication of rheumatoid arthritis (RA).
  • RV typically affects patients with established, erosive RA and involves small to medium-sized vessels.
  • Large vessel involvement in RV is less common but possible.

Purpose of the Study:

  • To report a case of de novo rheumatoid vasculitis (RV).
  • To highlight the diagnostic challenges of RV presenting before rheumatoid arthritis (RA) diagnosis.
  • To illustrate RV affecting small, medium, and large vessels in this unique presentation.

Main Methods:

  • Case report.
  • Clinical presentation and diagnostic workup of a patient with multisystem vasculitis.
  • Serological testing for rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies.

Main Results:

  • The patient presented with multisystem vasculitis affecting small, medium, and large vessels.
  • Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies were markedly elevated.
  • The diagnosis of rheumatoid vasculitis (RV) was confirmed prior to the diagnosis of rheumatoid arthritis (RA).

Conclusions:

  • Rheumatoid vasculitis (RV) can present as de novo multisystem vasculitis.
  • RV may precede the clinical diagnosis of rheumatoid arthritis (RA).
  • Elevated RF and anti-CCP antibodies are crucial for diagnosing RV, even before RA is established.