MYOCARDIAL AND VALVULAR FACTORS IN RHEUMATIC HEART DISEASE WITH MITRAL STENOSIS

1957 ◽  
Vol 233 ◽  
pp. 518-527 ◽  
Author(s):  
Louis A. Soloff ◽  
Jacob Zatuchni ◽  
George E. Mark
QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Adel ◽  
Tarek K Mosa ◽  
Ahmed Yehia ◽  
Ahmed Shawqi

Abstract Background Rheumatic heart disease remains a considerable cause of cardiovascular morbidity and mortality in developing countries and mitral stenosis is the most common valve affection of rheumatic heart disease worldwide.The left ventricular ejection fraction is the most widely used index of contractile function, but due to the visual component, assessment of endocardial excursion is subjective leading to inter-observer variability.Speckle-tracking echocardiography is an imaging technique developed as a method to objectively quantify myocardial function and analyzes cardiac motion and deformation by tracking naturally occurring speckle patterns in the myocardium. Objective To evaluate the effect of the severity of mitral stenosis on LV systolic function as assessed by speckle tracking. Patients and Methods This study was a case-control study involving 80 individuals which included 60 patients having mitral stenosis who presented to the outpatient clinics of Ain Shams University Hospitals and 20 healthy volunteers, The patients suffering from mitral stenosis were subdivided into 3 sub-groups: GROUP(1) 20 Patients having severe mitral stenosis (MV Area less than 1 cm²) GROUP (2) 20 Patients having moderate mitral stenosis (MV Area more than 1 cm² and less than 1.5 cm²) GROUP(3) 20 Patients having mild mitral stenosis (MV Area more than 1.5 cm²) A Control group involved 20 healthy volunteers recruited from health care workers in Ain Shams University hospitals. Results Study included 60 patients,16 males (26.7%) and 44 females (73.3%), with mean age of 41.30 ± 8.64 years. Patients living in rural Areas were 34 (57.7%) while those in urban areas were 26 (43.3%).Which was significant.There was no significant difference between gender or habitat and the severity of mitral Stenosis.There was a strong significance between the duration of the disease and its severity. The more the duration of mitral Stenosis, the more severe the mitral stenosis.A strong positive relation was noticed between the severity of mitral stenosis and both RVSP and LA diameter, while a strong negative relation between severity of mitral stenosis and GLPS. GLPS was affected in severe mitral stenosis only. Conclusion Subtle LV systolic dysfunction is present in large number of patients with severe mitral stenosis even in patients with normal ejection fraction by conventional 2D echocardiography.There was a significant relationship between the duration of mitral stenosis and its severity. The longer the duration of mitral stenosis, the more severe the mitral stenosis.Speckle tracking echocardiography (STE) can play a great role in identification of higher risk subgroups in whom earlier and more aggressive intervention could have a significant impact on their prognosis.


Author(s):  
Altaf Hussain ◽  
Faraz Farooq Memon ◽  
Iftikhar Ahmed ◽  
Syed Ahsan Raza ◽  
Lajpat Rai ◽  
...  

Objective: Mitral stenosis caused by rheumatic heart disease (RHD) is the most common cause of valvular lesion in adults and prevalent in developing countries like Pakistan. Higher natriuretic peptide (BNP) levels can be observed in patients with moderate to severe untreated mitral stenosis and are associated with higher rates of morbidity and mortality. That is why this study aims to determine the association between levels of pro-BNP with severity (mild. Moderate, and severe) of mitral stenosis. Patients and Methods: This was a clinical prospective study carried out in the department of adult cardiology, national institute of cardiovascular diseases, Karachi from 8th august 2019 to 7th February 2020. Total 68 patients of either gender with age between 25-70 years had mitral stenosis of moderate to severe intensity (mitral valve area ≤1.5 cm2), diagnosed on echocardiography were included for final analysis. A simple blood sample was taken for the assessment of pro-BNP levels. Questionnaire was used for demographic & clinical data collection and analysed using SPSS version 22.0. Results: The overall mean age of study subjects was 42.21±11.50 years, ranging from 25 – 70 years. Among them, females were prevalent (n = 43, 63.2%). The overall mean serum BNP level was 1071.12±807.26 pg/ml and the mean difference of serum BNP level was not significant among groups of gender, age, and diabetes mellitus with p>0.05. Significantly raised levels of BNP were observed in patients with severe mitral stenosis as compared to moderate mitral stenosis, p<0.05 Conclusion: In conclusion, the mean BNP levels were higher in patients with severe Mitral Stenosis. Therefore, BNP may be used to complement the clinical and echocardiographic assessments in patients with Mitral Stenosis.


2021 ◽  
Vol 6 (3) ◽  
pp. 278-280
Author(s):  
Shallu Chaudhary ◽  
Neha Atwal

We present a case report of a 28 year old pregnant female with moderate mitral stenosis who was posted for emergency caesarean section. The patient was given low dose subarachnoid block with injection bupivacaine (H) 7.5 mg and injection fentanyl 20 micrograms. Adequate intraoperative monitoring, optimum sedation, analgesia, oxygenation was done. Judicious use of intravenous fluids was considered. The patient maintained smooth intraoperative vitals. Postoperatively also the patient was monitored in the ICU and adequate analgesia was provided. Keywords: Rheumatic Heart Disease, Anaesthetic Management, Pregnancy, Mitral stenosis of rheumatic origin


Author(s):  
Abdul Qadir Khan Dall ◽  
Muhammed Kashif Shaikh ◽  
Syed Zulfiquar Ali Shah ◽  
Tarachand Devrajani ◽  
Abdul Salam Memon ◽  
...  

Background: Rheumatic Heart disease (RHD) is the leading cause of acquired heart disease and more prevalent in developing countries. The objective of the study was to determine the clinical and echocardiographic profiles of patients with rheumatic heart disease (RHD). Materials and Methods: All patients above the age of 12 years of either gender diagnosed with Rheumatic heart disease from January 2018 to December 2019 at tertiary care hospital, Hyderabad were enrolled in the study. Detailed patient data was obtained from the hospital records. Information regarding gender, age, Electrocardiogram findings, clinical and echocardiographic manifestations was obtained. Results: Throughout the two-year study period, a total of fifty patients with RHD were studied. The mean age of the population was 33.71 years. Females (64%) outnumbered males and 60% were rural population. The clinical features observed were fever (80%), joint pain (64%), palpitation (60%), breathlessness (90%) and chest pain (50%), tachycardia (60%), raised JVP (10%), hypertension (20%). The common echocardiographic findings observed were mitral stenosis (50%), mitral regurgitation (24%) and pulmonary hypertension (36%), left atrial enlargement (56%), and right atrial enlargement (16%) whereas the majority of the patients (70%) have ejection fraction between 40-50% and thrombus was identified in 15 (30%) patients respectively. Conclusion: Common clinical findings observed were breathlessness and fever while the common echocardiographic findings were mitral stenosis and regurgitation, pulmonary hypertension, and left atrial enlargement. Population-based screening by echocardiography could be a potential route for early screening of rheumatic heart disease.


PEDIATRICS ◽  
1954 ◽  
Vol 13 (5) ◽  
pp. 454-461
Author(s):  
PAUL R. LURIE ◽  
HARRIS B. SHUMACKER

Three patients, age 1-2, 14 and 15 years, presented symptoms of mitral stenosis to a disabling degree and were surgically relieved with dramatic effectiveness. These cases are reported, including catheterization data in two of the cases. The similarity of a very few cases of rheumatic heart disease in childhood to adult patients with mitral stenosis is pointed out. The criteria for selection of adult patients for mitral commissurotomy are equally applicable to children.


2020 ◽  
Vol 37 (4) ◽  
pp. 637-640
Author(s):  
Srilakshmi Vallabhaneni ◽  
Marsel Matka ◽  
Stephen Olenchock ◽  
Christopher Sarnoski ◽  
Santo Longo ◽  
...  

2019 ◽  
Vol 1 (3) ◽  
pp. 1-6
Author(s):  
Andrew S Lane ◽  
David J Clancy ◽  
Ian M Seppelt ◽  
Sam R Orde

Rheumatic heart disease is becoming far less common in the developed world, and therefore expsoure to its complications are been seen less by clinicians. With the increasing ease of world travel, patients with less commonly seen medical conditions are increasingly presenting to Hospitals requiring management of their complications. We present a case of an elderly lady who was a tourist in Australia, who presented with complications of her rheumatic heart disease, and her subsequent radiological and echocardiographic investigations were a significant surpirse for her treating clinicians.


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