scholarly journals Evaluation of congestive heart failure in children with rheumatic heart disease as a criterion of rheumatic activity.

1972 ◽  
Vol 31 (2) ◽  
pp. 134-136 ◽  
Author(s):  
Z H Abdin ◽  
M A Abul-Fadl
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Rheumatic Heart

MANIFESTATIONS AND TREATMENT OF CONGESTIVE HEART FAILURE IN YOUNG PATIENTS WITH RHEUMATIC HEART DISEASE

PEDIATRICS ◽  
1964 ◽  
Vol 33 (5) ◽  
pp. 661-671
Author(s):  
Alvan R. Feinstein ◽  
Aida C. Arevalo
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Common Symptom ◽  
Digitalis Toxicity ◽  
First Choice ◽  
Anti Inflammatory ◽  
Active Patients ◽  
Rheumatic Heart

This report analyzes the manifestations and treatment of 90 episodes of congestive heart failure in 40 children and adolescents with rheumatic heart disease. By use of specific clinical criteria, 34 episodes could be designated as part of "active" rheumatic inflammation, and 56 as "inactive." The most common signs in "active" and "inactive" groups were hepatic enlargement or tenderness, tachycardia, distention of neck veins, peripheral edema, and weight gain. The most common symptom was dyspnea, but it often was absent and, when present, was usually unaccompanied by rales. Three symptoms uncommon in the congestive failure of adults were frequently noted: cough, nausea, and a right upper quadrant abdominal ache. The latter finding was due to hepatic tenderness, demonstrated by a positive "liver slap" test, that often preceded palpable hepatomegaly and was sometimes the first evidence of decompensation. The "active" and "inactive" distinctions were therapeutically useful in that "active" episodes sometimes responded well to anti-inflammatory agents alone. Digitalis seemed to have equal occurrences of effectiveness or toxicity in "active" or "inactive" patients, and showed no major advantages over diuretics except when ventricular rates were rapid. In "active" patients, anti-inflammatory therapy seemed preferable and most beneficial only in the early untreated stages of the rheumatic attack. Although usually less effective than steroids for this purpose, salicylates were occasionally successful. Decompensation occurring as part of post-therapeutic rebounds in "active" patients could often be managed by digitalis or diuretics, without need for resumption of anti-inflammatory agents and their attendant risk of another post-therapeutic rebound. Except in the specific "active" and "inactive" instances cited above, we believe diuretics are a preferable first choice in the pharmaceutical treatment of the decompensated young rheumatic heart. Success with diuretics obviates not only the hazards of digitalis toxicity, but also the risk of inflammatory recrudescence after steroids.

Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal

2020 ◽  
Vol 01 (01) ◽  
pp. 009-012
Author(s):  
Laudari S
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Cross Sectional Study ◽  
Secondary Prophylaxis ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Rheumatic Heart

Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven ef􀏐icacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of de􀏐inite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardioward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43%) followed by aortic valve in 70 patients (20.00%) and rest 90 (25.71%) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14%) and arrhythmias in 155(44.29%) patients. Two hundred ten (60.00%) of the patients received penicillin (oral and injectable) and erythromycin. Majority 180/210=85.71%) were prescribed on oral penicillin whereas only 46/210=21.90% received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. Keywords: Rheumatic Heart Disease, Penicillin, Underuse, Secondary Prophylaxis.

scholarly journals The first reported case of Bartonella endocarditis in Thailand

2011 ◽  
Vol 3 (1) ◽  
pp. 9 ◽  
Author(s):  
Orathai Pachirat ◽  
Michael Kosoy ◽  
Ying Bai ◽  
Sompop Prathani ◽  
Anucha Puapairoj ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Heart Disease ◽  
Severe Congestive Heart Failure ◽  
Blood Cultures ◽  
Bartonella Species ◽  
Culture Techniques ◽  
Specific Culture ◽  
Culture Negative ◽  
Rheumatic Heart

Bartonella species have been shown to cause acute, undifferentiated fever in Thailand. A study to identify causes of endocarditis that were blood culture-negative using routine methods led to the first reported case in Thailand of Bartonella endocarditis A 57 year-old male with underlying rheumatic heart disease presented with severe congestive heart failure and suspected infective endocarditis. The patient underwent aortic and mitral valve replacement. Routine hospital blood cultures were negative but B. henselae was identified by serology, PCR, immunohistochemistry and specific culture techniques.

scholarly journals Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 142 (20) ◽  
Author(s):  
Raman Krishna Kumar ◽  
Manuel J. Antunes ◽  
Andrea Beaton ◽  
Mariana Mirabel ◽  
Vuyisile T. Nkomo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Treatment Options ◽  
Heart Association ◽  
Population Based ◽  
Diagnosis And Treatment ◽  
Optimal Care ◽  
Percutaneous Balloon ◽  
Rheumatic Heart

The global burden of rheumatic heart disease continues to be significant although it is largely limited to poor and marginalized populations. In most endemic regions, affected patients present with heart failure. This statement will seek to examine the current state-of-the-art recommendations and to identify gaps in diagnosis and treatment globally that can inform strategies for reducing disease burden. Echocardiography screening based on World Heart Federation echocardiographic criteria holds promise to identify patients earlier, when prophylaxis is more likely to be effective; however, several important questions need to be answered before this can translate into public policy. Population-based registries effectively enable optimal care and secondary penicillin prophylaxis within available resources. Benzathine penicillin injections remain the cornerstone of secondary prevention. Challenges with penicillin procurement and concern with adverse reactions in patients with advanced disease remain important issues. Heart failure management, prevention, early diagnosis and treatment of endocarditis, oral anticoagulation for atrial fibrillation, and prosthetic valves are vital therapeutic adjuncts. Management of health of women with unoperated and operated rheumatic heart disease before, during, and after pregnancy is a significant challenge that requires a multidisciplinary team effort. Patients with isolated mitral stenosis often benefit from percutaneous balloon mitral valvuloplasty. Timely heart valve surgery can mitigate the progression to heart failure, disability, and death. Valve repair is preferable over replacement for rheumatic mitral regurgitation but is not available to the vast majority of patients in endemic regions. This body of work forms a foundation on which a companion document on advocacy for rheumatic heart disease has been developed. Ultimately, the combination of expanded treatment options, research, and advocacy built on existing knowledge and science provides the best opportunity to address the burden of rheumatic heart disease.

scholarly journals RIGHT SIDED ENDOCARDITIS: CASE SERIES FROM MOROCCO

2021 ◽  
Vol 9 (4) ◽  
pp. 704-714
Author(s):  
A. Laalou ◽  
◽  
A. Chachi ◽  
A. Benbahia ◽  
S. Jourani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Rheumatic Heart Disease ◽  
Pulmonary Valve ◽  
Indwelling Catheters ◽  
Cardiac Devices ◽  
Wide Range ◽  
Rheumatic Heart

Objective: Compared with the extensive data on left sided infective endocarditis, right-sided infective endocarditis (RSIE) remains a rare condition. It accounts for 5–10% of all cases of infective endocarditis (IE) [1] [2] [3].Although it is predominantly encountered in the injecting drug user (IDU) population, where HIV and HCV infections often coexist, rheumatic heart disease remains the most important predisposing factor for IE in our context. The aim our study is to report clinical, investigation, management and outcome data in 5 patients diagnosed with RSIE in our department during the last 2 years. Methods: A retrospective analysis of data of 5 patients with right sided endocarditis in a tertiary care center from 2018 to 2020 was done. Results: All of our patients were young aged females none of them had cardiac devices or history of drug use. Persistent fever was the most common clinical presentation. Interestingly, 4 patients presented clinical heart failure. 3 patients had isolated tricuspid valve IE, one patient had isolated pulmonary valve IE, and one patient have both tricuspid and pulmonary valve IE. Blood cultures were negative in two cases, whilst two others were positive to Streptococcus (alpha) and one positive to Staphylococcus. 4 patients underwent surgical treatment after well conducted antibiotic therapy the indications were the presence of right heart failure secondary to severe tricuspid regurgitation and the size of the vegetations. Unfortunately, one patient died of massive pulmonary embolism despite well conducted antibiotherapy. Conclusion: RSIE is rare and occurs in a wide range of underlying conditions like implantable electronic devices, indwelling catheters, CHD and immune compromised state. Surprisingly, it can occur in young individuals without known risk factors. In our context, rheumatic heart disease remains the most incriminated etiology which lead us to question three essential points: 1. The interest of antibiotic prophylaxis in young patients with VSDs 2. The use of empiric antibiotics with action against streptococcus 3. Early surgical treatment in rheumatic heart disease.

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