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Biventricular assist for severe acute rheumatic pancarditis
B J Amsel1, H De Raedt, I E Rodrigus
1Department of Cardiac Surgery, University Hospital of Antwerp, Belgium.
The Annals of Thoracic Surgery
|July 1, 1996
Summary
Severe heart failure from acute rheumatic myocarditis is uncommon but can resolve quickly with prompt treatment. Aggressive medical management and mechanical support are crucial before considering heart transplantation.
Area of Science:
- Cardiology
- Rheumatology
- Immunology
Background:
- Acute rheumatic fever can lead to inflammatory heart disease, known as rheumatic heart disease.
- Myocarditis, inflammation of the heart muscle, is a potential complication of acute rheumatic fever.
- Severe heart failure is an infrequent but serious manifestation of acute rheumatic myocarditis.
Observation:
- Patients presenting with severe heart failure due to acute rheumatic myocarditis were identified.
- The clinical course and response to treatment in these patients were analyzed.
- The potential for rapid reversibility of cardiac dysfunction was noted.
Findings:
- Severe heart failure in acute rheumatic myocarditis, though rare, demonstrated potential for rapid improvement with appropriate medical intervention.
- Maximal medical therapy, including anti-inflammatory and supportive treatments, was essential for recovery.
- Mechanical circulatory support served as a critical bridge in cases not responding promptly to medical management.
Implications:
- Early and aggressive medical management is paramount for patients with acute rheumatic myocarditis and severe heart failure.
- Mechanical support should be considered judiciously as an adjunct to medical therapy.
- Heart transplantation should be reserved for refractory cases, emphasizing the potential for myocardial recovery.