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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...
548
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...
486
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

450
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
450
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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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...
500
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

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IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
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カワサキ 病 の 診断,治療,長期 的 な 治療: アメリカ 心臓 協会 から の 医療 専門家 の ため の 科学 的 な 声明

Brian W McCrindle, Anne H Rowley, Jane W Newburger

    Circulation
    |March 31, 2017
    PubMed
    まとめ

    更新されたガイドラインは,冠動脈に影響する子供の血管炎である川崎病の診断と管理のためのベストプラクティスを提供しています. 長期的な心臓合併症を予防するには 早期診断と個別化された治療が不可欠です

    キーワード:
    AHAの科学発表川崎症候群動脈瘤動脈炎冠動脈血管免疫グロブリン 静脈内投与トロンボシス血管炎

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    科学分野:

    • 小児心臓科
    • リウマトロジ
    • 血管生物学

    背景:

    • カワサキ病は,小児性心疾患の主要な原因です.
    • 治療されていない患者の約25%で冠動脈動脈瘤に繋がる 急性小児性血管炎です
    • カワサキ病の正確な原因は不明です.

    研究 の 目的:

    • カワサキ病に関するアメリカ心臓協会のガイドラインを改訂し,更新する.
    • 診断,急性治療,長期的な管理のための根拠に基づいた勧告を提供すること.
    • 疫学,遺伝学,病原性,結果に関する新しい洞察を組み込むこと.

    主な方法:

    • 既存の証拠と実践に基づいた意見の検討と評価をするために,多分野専門家による執筆グループが招集されました.
    • 古典的な臨床基準が不完全な症例を支援するために,更新された診断アルゴリズムが開発されました.
    • 治療抵抗性および進行中の冠動脈異常の管理のための勧告が確立されました.

    主要な成果:

    • カワサキ病の有効な管理には,早期診断が不可欠です.
    • 静脈内免疫グロブリンが主な初期治療法であり,反応しない患者には追加の治療が推奨されます (10 - 20%).
    • 長期的管理は冠動脈Zスコアに基づいてリスク分層化され,動脈瘤の患者の生涯の心臓学フォローアップが必要です.

    結論:

    • これらの更新された勧告は,川崎病の診断と管理のための証拠に基づいたガイドラインを提供します.
    • 特定の臨床的状況を考慮して,個別化された患者のケアが最重要です.
    • 冠動脈動脈瘤の患者には生涯の心臓病の追跡が不可欠です.