scholarly journals MANAGEMENT OF SEVERE XEROSTOMIA AND ORAL CANDIDIASIS IN PATIENT WITH VALVULAR HEART DISEASE: A CASE REPORT

2021 ◽  
Vol 6 (2) ◽  
pp. 209
Author(s):  
Helen Christine ◽  
Tenny Setiani Dewi ◽  
Wahyu Hidayat
Keyword(s):  
Heart Disease ◽  
Antibiotic Treatment ◽  
Valvular Heart Disease ◽  
Beta Blockers ◽  
Oral Candidiasis ◽  
Disease Patient ◽  
Severe Infection ◽  
Vascular Medicine ◽  
Converting Enzyme Inhibitors

Background: Valvular heart disease is a heart valve disorder that needs complex multiple medications by administering certain drugs that cannot be replaced with other drugs because of different mechanisms of action. Beta-blockers and Angiotensin-Converting Enzyme inhibitors are drugs of choice for valvular heart disease, with diuretics and antipsychotics can cause xerostomia. Valvular heart disease patient who has a severe infection or sepsis needs long-term antibiotic treatment. Xerostomia and long-term antibiotic treatment are predisposing factors for oral candidiasis. Objective:  to discuss oral candidiasis and severe xerostomia because of multiple medications in valvular heart disease patients. Case: A 58-year-old male was referred from Cardiology and Vascular Medicine Department with a chief complaint of sore tongue and pain at swallowing since 3 days ago with dry sensation of the mouth. Extraoral examination revealed dry and exfoliative lips, intraoral examination revealed fissured and lobulated tongue and white plaques could be scraped off leaving erythematous area oropharynx and tongue. The diagnoses were oropharyngeal candidiasis and severe xerostomia score of 8 according to the Chalacombe scale. Case Management: Patient was treated with nystatin, chlorine dioxide, 0.12 % chlorhexidine digluconate mouthwash, and vaseline album. Oral candidiasis was disappeared on the 22nd day of treatment. Conclusion:  Xerostomia and oral candidiasis in patients with valvular heart disease require appropriate therapy, more intensive monitoring by considering the patient's general condition, and interprofessional team collaboration in the therapy of the main disease. Keywords: Oral candidiasis, Valvular heart disease, Xerostomia

scholarly journals Preliminary results of the acute Heart Failure registry in the DELTA region of Egypt (DELTA-HF): a database and a quality initiative project

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Abdelfatah Elasfar ◽  
Sherif Shaheen ◽  
Wafaa El-Sherbeny ◽  
Hatem Elsokkary ◽  
Suzan Elhefnawy ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Acute Heart Failure ◽  
Valvular Heart Disease ◽  
Beta Blockers ◽  
Left Ventricular Ejection ◽  
Systemic Hypertension ◽  
Delta Region ◽  
Device Therapy ◽  
Short Term

Abstract Background Data about heart failure in Egypt is scarce. We aimed to describe the clinical characteristics and diagnostic and treatment options in patients with acute heart failure in the Delta region of Egypt and to explore the gap in the management in comparison to the international guidelines. Results DELTA-HF is a prospective observational cohort registry for all consecutive patients with acute heart failure (AHF) who were admitted to three tertiary care cardiac centers distributed in the Delta region of Egypt. All patients were recruited in the period from April 2017 to May 2018, during which, data were collected and short-term follow-up was done. A total of 220 patients (65.5% were males with a median age of 61.5 years and 50.9% had acute decompensation on top of chronic heart failure) was enrolled in our registry. The risk factors for heart failure included rheumatic valvular heart disease (10.9%), smoking (65.3%), hypertension (48.2%), diabetes mellitus (42.7%), and coronary artery disease (28.2%). Left ventricular ejection fraction (LVEF) was less than 40% in 62.6%. Etiologies of heart failure included ischemic heart disease (58.1%), valvular heart disease (16.3%), systemic hypertension (9.1%), and dilated non-ischemic cardiomyopathy (15.5%). Exacerbating factors included infections (28.1%), acute coronary syndromes (25.5%), non-compliance to HF medications (19.6%), and non-compliance to diet (23.2%) in acute decompensated heart failure (ADHF) patients. None of our patients had been offered heart failure device therapy and only 50% were put on beta-blockers upon discharge. In-hospital, 30 days and 90 days all-cause mortality were 18.2%, 20.7%, and 26% respectively. Conclusions There is a clear gap in the management of patients with acute heart failure in the Delta region of Egypt with confirmed under-utilization of heart failure device therapy and under-prescription of guideline-directed medical therapies particularly beta-blockers. The short-term mortality is high if compared with Western and other local registries. This could be attributed mainly to the low-resource health care system in this region and the lack of formal heart failure management programs.

scholarly journals Long-term risk of second malignancy and cardiovascular disease after Hodgkin lymphoma treatment

Hematology ◽  
2016 ◽  
Vol 2016 (1) ◽  
pp. 323-330 ◽  
Author(s):  
Flora E. van Leeuwen ◽  
Andrea K. Ng
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Hodgkin Lymphoma ◽  
Valvular Heart Disease ◽  
Premature Menopause ◽  
Malignant Neoplasms ◽  
Cardiovascular Toxicity ◽  
Solid Malignancies ◽  
Increased Risk

Abstract Long-term survivors of Hodgkin lymphoma (HL) experience several late adverse effects of treatment, with second malignant neoplasms (SMNs) and cardiovascular diseases (CVDs) being the leading causes of death in these patients. Other late effects have also been identified, such as pulmonary dysfunction, endocrinopathies (thyroid dysfunction, infertility), neck muscle atrophy, and persistent fatigue. HL survivors have two- to fourfold increased risks to develop SMNs and CVD compared with the general population. With respect to SMNs, radiotherapy is associated with 1.5- to 15-fold increased risk of solid malignancies. The relative risk (RR) of solid tumors increases steadily with increasing follow-up time from 5 to 15 years since radiotherapy, and remains elevated for at least 40 years. The RR of solid SMNs increases strongly with younger age at first treatment. Risks of lung, breast, and gastrointestinal (GI) cancers increase with higher radiation dose. Alkylating agent chemotherapy, especially procarbazine, does not only increase risk of leukemia but also of solid malignancies, in particular, cancers of the lung and GI tract. In contrast, gonadotoxic chemotherapy decreases the risk of radiation-associated breast cancer, through induction of premature menopause. Smoking appears to multiply the radiation- and chemotherapy-associated risks of lung cancer. Both radiotherapy and chemotherapy for HL may cause cardiovascular toxicity. Radiotherapy increases the risk of coronary heart disease, valvular heart disease, congestive heart failure (HF), and pericarditis, whereas anthracycline-containing chemotherapy increases the risks of HF and valvular heart disease. Cardiovascular toxicity following radiotherapy is usually observed from 5 to at least 35 years after therapy, whereas anthracycline-related toxicity is already observed during treatment, up to at least 25 years. The joint effects of anthracyclines, radiotherapy, and conventional cardiovascular risk factors (eg, hypertension, smoking, and physical inactivity) appear to be additive rather than multiplicative. HL survivors need lifelong risk-based screening for selected SMNs and CVDs. Furthermore, preventive strategies should include lifestyle and drug-based interventions to minimize exposure to conventional risk factors for cancer and CVD.

scholarly journals Clinical Characteristics and Long-Term Prognosis of Elderly Valvular Heart Disease Patients with Diabetes Mellitus: Five-Year Experience from a Single-Center Study of Southern China

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yuan-Feng Liang ◽  
Feier Song ◽  
Huixia Liu ◽  
Jian Liu ◽  
Yu-Yuan Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Valvular Heart Disease ◽  
Protective Factor ◽  
Independent Predictor ◽  
Single Center ◽  
Long Term Outcome

Background. Diabetes mellitus (DM) is a prognostic marker in elderly patients with cardiovascular diseases, but its predictive value in elderly valvular heart disease (VHD) patients is unclear. This study aimed to investigate the effect of DM on the long-term outcome of elderly VHD patients. Methods. This single-center, observational study enrolled patients aged 65 and older consecutively with confirmed VHD using echocardiography. Patients, divided into the DM group and non-DM group, were followed up for major adverse cardiac and cerebrovascular events (MACCEs), including all-cause death, ischemic stroke, and heart failure rehospitalization. Results. Our study consisted of 532 patients over a median follow-up of 52.9 months. Compared with the non-DM group (n = 377), the DM group (n = 155) had higher incidences of ischemic stroke (25.2% vs. 13.5%, P = 0.001 ), heart failure rehospitalization (37.4% vs. 20.7%, P < 0.001 ), and MACCEs (60.0% vs. 35.8%, P < 0.001 ). After adjustment of confounders by the multivariable cox regression, DM appeared as an independent predictor for MACCEs (adjusted hazard ratio, aHR: 1.88; 95% confidence interval 1.42–2.48; P < 0.001 ). In the subgroup analysis of VHD etiology and functional style, conversely, DM was a protective factor for MACCEs in the patients with rheumatic VHD compared with those without rheumatic VHD (aHR: 0.43 vs. 2.27, P = 0.004 ). Conclusions. DM was an independent predictor for ischemic stroke and heart failure rehospitalization in elderly VHD patients undergoing conservative treatment.

scholarly journals Heart failure requiring hospitalization in patients after cardiac surgery for valvular heart disease

2019 ◽  
Vol 26 (2) ◽  
pp. 57-62
Author(s):  
A. V. Zhadan
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Reverse Remodeling ◽  
Damage Indicators ◽  
Heart Pathology ◽  
Permanent Form

The aim – to determine the factors associated with the frequency of hospitalizations for decompensation of heart failure (HF) after cardiac surgery in patients with valvular heart disease. Materials and methods. 235 patients who underwent cardiac surgery for valvular heart disease were examined. During the period from 2014 to 2017, a part of patients (129 people) had no hospitalizations, while 106 people were on inpatient treatment from 1 to 10 times, on average 2.78±1.95. The complex of examination of patients along with physical examination included electrocardiography, echocardiography. Results and discussion. During dynamic observation for 2 years in the group of patients without hospitalization, a progressive statistically significant decrease in the size of the left atrium (LA) and left ventricle (LV) as well as an increase in LV contractility were noted, while in the group of patients after hospitalization such changes were not observed. The dimensions of the chambers of the heart remained practically unchanged for 2 years. Thus, it can be concluded that the more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers. Predictors of hospitalizations for HF are the presence of diabetes mellitus, hypertension and permanent form of atrial fibrillation. Conclusions. The probability of progression of heart failure in patients after cardiosurgical intervention for valvular heart pathology is not affected by sex, age, type of lesion of the valve, etiology of valve damage, indicators of echocardiography. Predictors of hospitalizations for heart faiure in the long-term postoperative period are the presence of diabetes, AF, and AH. The more severe course of heart failure after prosthetics of heart valves is accompanied by the absence of reverse remodeling of the heart chambers.

Community prevalence, mechanisms and outcome of mitral or tricuspid regurgitation

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318482
Author(s):  
Thomas J Cahill ◽  
Anthony Prothero ◽  
Jo Wilson ◽  
Andrew Kennedy ◽  
Jacob Brubert ◽  
...  
Keyword(s):  
Heart Disease ◽  
Tricuspid Regurgitation ◽  
Valvular Heart Disease ◽  
Surgical Intervention ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Age Dependent ◽  
Study Population

ObjectiveThe study aims were (1) to identify the community prevalence of moderate or greater mitral or tricuspid regurgitation (MR/TR), (2) to compare subjects identified by population screening with those with known valvular heart disease (VHD), (3) to understand the mechanisms of MR/TR and (4) to assess the rate of valve intervention and long-term outcome.MethodsAdults aged ≥65 years registered at seven family medicine practices in Oxfordshire, UK were screened for inclusion (n=9504). Subjects with known VHD were identified from hospital records and those without VHD invited to undergo transthoracic echocardiography (TTE) within the Oxford Valvular Heart Disease Population Study (OxVALVE). The study population ultimately comprised 4755 subjects. The severity and aetiology of MR and TR were assessed by integrated comprehensive TTE assessment.ResultsThe prevalence of moderate or greater MR and TR was 3.5% (95% CI 3.1 to 3.8) and 2.6% (95% CI 2.3 to 2.9), respectively. Primary MR was the most common aetiology (124/203, 61.1%). Almost half of cases were newly diagnosed by screening: MR 98/203 (48.3%), TR 69/155 (44.5%). Subjects diagnosed by screening were less symptomatic, more likely to have primary MR and had a lower incidence of aortic valve disease. Surgical intervention was undertaken in six subjects (2.4%) over a median follow-up of 64 months. Five-year survival was 79.8% in subjects with isolated MR, 84.8% in those with isolated TR, and 59.4% in those with combined MR and TR (p=0.0005).ConclusionsModerate or greater MR/TR is common, age-dependent and is underdiagnosed. Current rates of valve intervention are extremely low.

scholarly journals Role of antihypertensive drugs in the treatment of migraine

2015 ◽  
Vol 156 (5) ◽  
pp. 179-185 ◽  
Author(s):  
Gergely Fehér ◽  
Gabriella Pusch
Keyword(s):  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Migraine Prevention ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

The treatment of migraine depends on the frequency, severity and concomitant diseases. There are several specific drugs developed for migraine prevention in addition to the additive antimigraine effects of some other non-specific drugs. The aim of this literature-based review is to summarize the possible antimigraine properties of different antihypertensive agents (beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, etc.) focusing on the possible side effects (avoidance of beta blockers in the absence of heart disease, possible antiparkinson effect of calcium channel blockers, additive effect of drugs modifying the renin-angiotensin system activity, etc.). Current evidence supports the use of angiotensin converting enzyme inhibitors (mainly lisinopril) and angiotensin receptor blockers (mainly candesartan) for long-term migraine prevention and blood pressure control. Long-term beta-blocker treatment should be avoided in the absence of ischemic heart disease due to possible unfavourable cardiovascular effects. Orv. Hetil., 2015, 156(5), 179–185.

Long-Term Results of Heart Transplantation for End-Stage Valvular Heart Disease

2009 ◽  
Vol 24 (5) ◽  
pp. 580-584 ◽  
Author(s):  
Yanto Sandy Tjang ◽  
Geert J. M. G. van der Heijden ◽  
Gero Tenderich ◽  
Reiner Körfer ◽  
Diederick E. Grobbee
Keyword(s):  
Heart Disease ◽  
Heart Transplantation ◽  
Valvular Heart Disease ◽  
Long Term Results ◽  
End Stage

scholarly journals COMBINED MITRAL AND TRICUSPID STENOSIS IN 47-YEAR OLD RHEUMATIC VALVULAR HEART DISEASE PATIENT: A CASE REPORT

2020 ◽  
Vol 14 (2) ◽  
pp. 153-156
Author(s):  
*Ejeagba OO ◽  
◽  
*Ayoola YA ◽  
*Ejeh AB ◽  
*Adamu A ◽  
...  
Keyword(s):  
Heart Disease ◽  
Left Atrium ◽  
Valvular Heart Disease ◽  
Systolic Dysfunction ◽  
Disease Patient ◽  
Hypertensive Heart Disease ◽  
Left Ventricular ◽  
Valve Disease ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background: Rheumatic valvular heart disease is a common complication of rheumatic fever; however combined mitral and tricuspid stenosis is an extremely rare form of multi-valve disease presentation. Case Presentation: We report a case of combined mitral and tricuspid stenosis from rheumatic heart disease (RHD) in a 47-year-old woman who was being managed for hypertensive heart disease (HHDx) on anti-hypertensives for 2yrs prior to presentation. However, on further review with transthoracic echocardiography (TTE), she was found to have thickened mitral valve and hockey stick appearance with dilated left atrium (dimension of 60mm) and reduced left ventricular ejection fraction (LVEF) of 45%. A repeat TTE done 8 years after the first one showed a severely dilated left atrium (LAD 71mm) with estimated area of 55.4cm2; moderate mitral stenosis and severe tricuspid stenosis with moderate TR. The LVEF was 29% with a severe right ventricular (RV) systolic dysfunction (TAPSE of 9mm). Patient is being managed conservatively due to economic constraints and the likelihood of very poor surgical outcome due to severe biventricular dysfunction. Conclusion: The case is reported for its rarity as well as the importance of interval evaluation of unaffected valves in a setting of single valve disease for early detection and possible prompt treatment and intervention.

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