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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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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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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
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Myocarditis II: Clinical Features and Diagnostic Tests01:27

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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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Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

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Updated: Sep 9, 2025

Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
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Characteristics Associated With Detectable High-Sensitivity Cardiac Troponin in Patients With Rheumatoid Arthritis at

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ACR Open Rheumatology
|August 29, 2025
PubMed
Summary
This summary is machine-generated.

Detectable high-sensitivity cardiac troponin T (hs-cTnT) is common in rheumatoid arthritis (RA) patients with low to intermediate cardiovascular risk. Older age and male sex are linked to higher hs-cTnT levels, suggesting targeted screening for these individuals.

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Area of Science:

  • Cardiology
  • Rheumatology
  • Biomarkers

Background:

  • Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) risk.
  • Subclinical myocardial injury, indicated by detectable high-sensitivity cardiac troponin T (hs-cTnT), is linked to adverse cardiac events in RA.
  • Identifying factors associated with detectable hs-cTnT in RA patients with low to intermediate atherosclerotic cardiovascular disease (ASCVD) risk is crucial for risk stratification.

Purpose of the Study:

  • To identify factors associated with detectable hs-cTnT in patients with RA at low to intermediate ASCVD risk.
  • To determine if clinical factors and available biomarkers predict detectable hs-cTnT independently of ASCVD risk scores.

Main Methods:

  • A cross-sectional cohort study of 294 RA patients without pre-existing CVD or high ASCVD risk (>20%).
  • Univariable analysis compared demographics, RA clinical factors, inflammation markers, and lipids between patients with and without detectable hs-cTnT.
  • Multivariable logistic regression models were used to identify independent predictors of detectable hs-cTnT.

Main Results:

  • 29% (86/294) of RA patients had detectable hs-cTnT.
  • Detectable hs-cTnT was associated with older age, male sex, hypertension, elevated inflammatory markers (hs-CRP, IL-6), lipoprotein-associated phospholipase A2, glucocorticoid use, and absence of methotrexate use.
  • Higher 10-year ASCVD risk was associated with detectable hs-cTnT (OR 1.22); however, inflammatory markers were not significant in multivariable analysis.
  • In the lowest ASCVD risk category (<5%), over 25% of men and 33% of patients >60 years had detectable hs-cTnT.

Conclusions:

  • Detectable hs-cTnT is prevalent in RA patients with low to intermediate ASCVD risk.
  • Male sex and age >60 are key factors associated with detectable hs-cTnT in this population.
  • These findings suggest a need for enhanced cardiovascular screening in older male RA patients, irrespective of their calculated ASCVD risk.