Presentation
Mild aortic regurgitation (AR) was also present. Blood cultures remained sterile; however, she received a course of penicillin prior to her hospital presentation. Antibiotics followed for culture-negative endocarditis. [bloodjournal.org]
In five valves, the helper T cells exceeded the number of suppressor T cells, whereas in three others, helper and cytotoxic/suppressor T cells were present in equal numbers. [ncbi.nlm.nih.gov]
Through the case of a 41-year-old Caucasian female who presented with progressive dyspnea and symptoms of heart failure, due to subacute rheumatic valvulitis, the importance of multimodality cardiovascular imaging assessment of patients presenting with [ingentaconnect.com]
Benefit from matchless Netter illustrations that offer precision, clarity, detail and realism as they provide a visual approach to the clinical presentation and care of the patient. [books.google.de]
Entire Body System
-
Pediatric Disease
Brand-new chapters and comprehensive revisions throughout ensure that you have the most recent information on diagnosis and treatment of pediatric diseases based on the latest recommendations and methodologies. [books.google.de]
Liver, Gall & Pancreas
-
Jaundice
A 13-year-old girl was admitted with congestive heart failure, edema, ascites, and jaundice. There was an apical pansystolic murmur of mitral insufficiency and marked cardiomegaly. Her venous pressure was elevated. [ncbi.nlm.nih.gov]
Cardiovascular
-
Heart Disease
The latest case series (2007) [8] is a cohort of 25 young rheumatic heart disease (RHD) patients who underwent surgery during an acute RF episode. [heartindia.net]
The presence of rheumatic heart disease and cardiomegaly may have led to the exacerbation of symptoms and signs of constrictive pericarditis and severe right heart failure. [ncbi.nlm.nih.gov]
New to the third edition are: - Expanded coverage of the coronary heart disease syndromes; congestive heart failure; arrhythmias; pacing; sudden death; lipid management (including clinical results), and a completely revised and updated section on noninvasive [books.google.de]
Abstract While MHA has been frequently reported with mechanical heart valves, hemolysis associated with native valvular heart disease is rare. A 20-year-old Amish female presented with left hip arthritis in 5/03. [bloodjournal.org]
-
Heart Murmur
[…] from normal and abnormal heart sounds Diastolic heart murmurs are heart murmurs heard during diastole.[1] … Wikipedia verrucous vegetations — small irregular fibrinous excrescences usually occurring along the line of closure of the cardiac valve cusps [medicine.academic.ru]
Echocardiography/Doppler findings not consistent with carditis should exclude that diagnosis in patients with a heart murmur otherwise thought to indicate rheumatic carditis (Class I, Level of Evidence B). [acc.org]
Carditis is most commonly detected when a new heart murmur has been auscultated or when tachycardia out of proportion to the fever is observed. [atsu.edu]
Carditis: pancarditis Pericardial friction rubs Weak heart sounds Tachycardia & arrhythmias New heart murmurs. other clinical features include epistaxis & abdominal pain. 24. Myocarditis may cause cardiac dilatation leading to mitral valve insufficiency [slideshare.net]
Only two patients with subclinical valvulitis developed heart murmur during the follow-up, after recurrence with carditis. [ncbi.nlm.nih.gov]
-
Systolic Murmur
This picture together with a systolic murmur, pericardial friction rub and an ESR of 118 mm/h prompted a transesophageal echocardiogram (TEE) revealing a myxomatous mitral valve (MV) with severe MR and thickening of the tip of the posterior leaflet of [bloodjournal.org]
The cardiovascular system examination showed normal heart sounds, S1 soft, 3/6 presystolic murmur at the apex radiating to the axilla, 2/6 systolic murmur at the left lower sternal border and in the pulmonary area, and 2/6 diastolic murmur in the apex [heartindia.net]
This case does not present a better description of systolic murmur audible in the aortic area. [scielo.br]
Case Report A 10-year-old female child was referred for echocardiographic evaluation with an apical systolic murmur. [scirp.org]
-
Cardiac Signs and Symptoms
The book and DVD package is designed to provide comprehensive coverage of every aspect of cardiovascular medicine from cardiac signs and symptoms and the full range of cardiac imaging techniques through management of peripheral vascular disease and the [books.google.de]
-
Pansystolic Murmur
There was an apical pansystolic murmur of mitral insufficiency and marked cardiomegaly. Her venous pressure was elevated. [ncbi.nlm.nih.gov]
Psychiatrical
-
Denial
Rely on TCI and avoid unspecified code denials once and for all. [books.google.de]
Neurologic
-
Polyneuropathy
Associated Infections; Intrapartum and Peripartum Infections; Bath salts and other drugs of abuse; Small Fiber Polyneuropathy; Microbiome; Kingella kingae; Mitochondrial Neurogastrointestinal Encephalomyopathy; Nonalcoholic Fatty Liver Disease; Plagiocephaly [books.google.de]
-
Catatonia
[…] techniques and approaches with complete updates throughout 35 new chapters, including: Innovations in Addressing Child Health and Survival in Low Income Settings; Developmental Domains and Theories of Cognition; The Reggio Emilia Educational Approach Catatonia [books.google.de]
Workup
Serum
-
Heinz Bodies
Heinz bodies were not present. Ham’s test was without hemolysis. Lupus anticoagulant, anticardiolipin antibody, ANA, rheumatoid factor, antidouble-strand DNA, p-ANCA and c-ANCA were not present. ASO was 200 U/mL. [bloodjournal.org]
Treatment
Holmes Springer Science & Business Media, 06.12.2007 - 2926 Seiten Cardiovascular Medicine, 3rd Edition offers the most up-to-date, user-friendly guidance on the evaluation, diagnosis and medical and surgical treatment of heart and vascular disease and [books.google.de]
Despite medical treatment her condition deteriorated, hepatic and renal failure as well as disseminated intravascular coagulation ensued, leading to her death. [ncbi.nlm.nih.gov]
Statistics and Research Methods Stem Cell Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment [jamanetwork.com]
The first-line treatment is penicillin, and is combined with symptomatic anti-inflammatory treatment, typically with salicylates or glucocorticoids (if salicylates are not effective). [amboss.com]
Prognosis
Abstract The prognosis for 115 rheumatic fever patients subsequently receiving regular intramuscular penicillin prophylaxis for at least 5 years was studied. Average follow-up was 9.3 years, and 57 patients were followed for 10 years or longer. [circ.ahajournals.org]
valproic acid ) Prognosis : Usually self-limiting If treated, full remission usually occurs within 3–4 months. [amboss.com]
The presence of arthritis as well as the presence of chorea in the initial attack were related to a better prognosis in relation to significant valvular heart disease. [ncbi.nlm.nih.gov]
Outcome Several factors play a role in the prognosis of IE (infective endocarditis). Costa, et al. described the clinical and echocardiographic scores as the predictors of mortality in infective endocarditis. [scirp.org]
PROGNOSIS In cases of primary attack is excellent with only 1% cases dying from fulminant RF 25. [slideshare.net]
Etiology
The pathologic picture of pericarditis was nonspecific, but in presence of a positive skin test for tuberculosis the latter is considered to be the most likely cause of the pericarditis, nevertheless, rheumatic etiology of pericarditis in this case cannot [ncbi.nlm.nih.gov]
Etiology Streptococcus pyogenes (group A Streptococcus ) is the etiological agent that induces an autoimmune reaction that results in damage to the heart. This complication occurs several weeks after a pharyngeal infection with S pyogenes. [atsu.edu]
Possibly the etiology of such involvement is by extemporaneous development of rheumatic fever, with late involvement of this valve. [scielo.br]
New observations on the etiology of aortic valve disease: a surgical pathologic study of 236 cases from 1990. Hum Pathol. 1993 Dec. 24(12):1330-8. [Medline]. Veinot JP. Pathology of inflammatory native valvular heart disease. [emedicine.medscape.com]
Etiology Most commonly accepted mechanism : Group A β-hemolytic streptococcus ( Streptococcus pyogenes ) (G AS) : ac ute tonsillitis or pharyngitis (“ strep throat ”) without antibiotic treatment antibodies develop against streptococcal M protein cross-reaction [amboss.com]
Epidemiology
Epidemiologic implications: It is reasonable to consider individuals at low risk of ARF if they come from a setting or population with known low rates of ARF and RHD (Class IIa, Level of Evidence C). [acc.org]
References: [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia’s Northern Territory. Trop Med Int Health 2015;20:40-7. Kim S, Lee NY. [nps.org.au]
Epidemiology Forced exercise, pregnancy, use of steroids or nonsteroidal anti-inflammatory agents, use of ethanol, and nutritional deficiencies are factors that predispose a patient to symptomatic myocarditis. [atsu.edu]
Rheumatic chorea in northern Australia: a clinical and epidemiological study. Arch Dis Child. 1999; 80 :353–8. [ PMC free article ] [ PubMed ] [ Google Scholar ] [ncbi.nlm.nih.gov]
Pathophysiology
Pathophysiology of rheumatic heart disease Micrograph showing an Aschoff body (right of image), as seen in rheumatic heart disease. [textbookofcardiology.org]
inappropriate laughing/crying, agitation, anxiety, apathy, obsessive-compulsive behavior) Epidemiology ( 2:1 ) Longer latent period than other rheumatic manifestations (presents several months following GAS infection ) Pathophysiology : Streptococcal [amboss.com]
Etiology and Pathophysiology Rheumatic fever is a late inflammatory, nonsuppurative complication of pharyngitis that is caused by group A-hemolytic streptococci. [4] Rheumatic fever results from humoral and cellular-mediated immune responses occurring [emedicine.medscape.com]
Curr Opin Rheumatol 24:408, 2012 [PMID:22617826] Comment: Comprehensive review focuses upon the pathophysiology known that leads GAS to cause ARF and RHD. Parnaby MG, Carapetis JR: Rheumatic fever in indigenous Australian children. [hopkinsguides.com]
Prevention
[…] comprehensive coverage of every aspect of cardiovascular medicine from cardiac signs and symptoms and the full range of cardiac imaging techniques through management of peripheral vascular disease and the genetic basis for cardiovascular disease to preventive [books.google.de]
Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive [jamanetwork.com]
Vegetation can prevents leaflet coaptation, and valvular retraction during the healing phase of endocarditis and result in mitral regurgitation. [scirp.org]
References: [4] [16] [17] Prognosis Prevention Primary prevention : prompt antibiotic treatment (e.g., penicillin V ) of GAS tonsillopharyngitis diagnosed by throat culture or rapid strep test Secondary prevention Antibiotic prophylaxis to prevent recurrence [amboss.com]
Timor Leste). 34 This adds a further challenge to the prevention of this serious and potentially fatal condition. [nps.org.au]