Perioperative Management of Patients with Breast Cancer Complicated with Rheumatic Heart Disease

Objective:Â To investigate the perioperative treatment of patients with breast cancer complicatedÂ with rheumatic heartÂ disease. Methods:Â The perioperative treatment of rheumaticÂ heart disease in 2400 patients with breast cancer treated inÂ our hospital from January 2007 to August 2011 were retrospectively analyzed. Results: Two of the 2400 patients withÂ breast cancer had rheumatic heart disease, aged 71 and 55Â years, respectively. One case with atrial fibrillation, and theÂ other one case of mitral valve replacement valve, were treatedÂ with warfarin anticoagulant therapy. Two patients in the first 5Â days before the withdrawal of warfarin, while low molecularÂ weight heparin or fondaparinux sodium anticoagulant therapy,Â intraoperative careful hemostasis, as appropriate after the startÂ of anticoagulant therapy. Patients within 24 hours after the incision area ofÂ ecchymosis, to adjust the anticoagulant drugs,Â to strengthen the drainage and hemostasis and other measuresÂ improved. Conclusion: Patients with breast cancer complicated with rheumatic heart disease are more complicated due toÂ basic diseases, and their perioperative treatment is more complicated. Excessive anticoagulation or hemostatic treatmentÂ will lead to adverse reactions. Perioperative attention shouldÂ be paid to monitor and adjust the patient INR value, intraoperative need to carefully hemostasis, as far as possible to stopÂ bleeding, reduce coagulation, close observation of patientsÂ with local wound conditions, strengthen drainage, if necessary,Â add hemostatic, and more can be better The treatment effect.

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Perioperative Management of Patients with Breast Cancer Complicated with Rheumatic Heart Disease

Proceedings of Anticancer Research ◽

10.26689/par2017.v1i1.17 ◽

2017 ◽

Vol 1 (1) ◽

pp. 15-18

Author(s):

Xing Lei ◽

Liu Hong

Keyword(s):

Breast Cancer ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Perioperative Management ◽

Rheumatic Heart

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Hypermethylation of brain natriuretic peptide gene is associated with the risk of rheumatic heart disease

Bioscience Reports ◽

10.1042/bsr20160408 ◽

2017 ◽

Vol 37 (1) ◽

Cited By ~ 3

Author(s):

Ni Li ◽

Dawei Zheng ◽

Lebo Sun ◽

Huoshun Shi ◽

Xiuying Zhu ◽

...

Keyword(s):

Heart Disease ◽

Brain Natriuretic Peptide ◽

Rheumatic Heart Disease ◽

Natriuretic Peptide ◽

Anticoagulant Therapy ◽

Significant Difference ◽

Term Administration ◽

Promoter Dna ◽

Peptide Gene ◽

Rheumatic Heart

To investigate the contribution of brain natriuretic peptide (BNP) promoter DNA methylation to the risk of rheumatic heart disease (RHD) and the influence of warfarin anticoagulant therapy on BNP methylation levels for RHD patients after surgery. BNP methylation levels were determined by bisulfite pyrosequencing from plasma samples of RHD patients compared with healthy controls. Several factors influencing the RHD patients were included like age, smoking and cholesterol levels. A fragment of five CG sites (CpG1–5) in the promoter region of BNP gene was measured. BNP gene hypermethylation was found in CpG4 and CpG5 in RHD patients compared with non-RHD controls. A significant difference was also observed between RHD patients with long-term administration of warfarin and RHD patients who had recently undergone an operation. Moreover, single CpG4 and CpG5 analysis revealed a significant increase in methylation levels in men. BNP gene body hypermethylation is associated with the risk of RHD, and also influenced by the warfarin anticoagulant therapy of RHD patients after surgery, which could represent novel and promising targets for therapeutic development.

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Severe adverse events following benzathine penicillin G injection for rheumatic heart disease prophylaxis: cardiac compromise more likely than anaphylaxis

Heart Asia ◽

10.1136/heartasia-2019-011191 ◽

2019 ◽

Vol 11 (2) ◽

pp. e011191 ◽

Cited By ~ 4

Author(s):

Shannon Marantelli ◽

Robert Hand ◽

Jonathan Carapetis ◽

Andrea Beaton ◽

Rosemary Wyber

Keyword(s):

Heart Disease ◽

Adverse Events ◽

Rheumatic Heart Disease ◽

Adverse Reactions ◽

Case Reports ◽

Penicillin G ◽

Alternative Mechanism ◽

Benzathine Penicillin ◽

Benzathine Penicillin G ◽

Rheumatic Heart

ObjectiveSecondary prophylaxis through long-term antibiotic administration is essential to prevent the progression of acute rheumatic fever to rheumatic heart disease (RHD). Benzathine penicillin G (BPG) has been shown to be the most efficacious antibiotic for this purpose; however, adverse events associated with BPG administration have been anecdotally reported. This study therefore aimed to collate case reports of adverse events associated with BPG administration for RHD prophylaxis.Study designA literature review was used to explore reported adverse reactions to BPG and inform development of a case report questionnaire. This questionnaire was circulated through professional networks to solicit retrospective reports of adverse events from treating physicians. Returned surveys were tabulated and thematically analysed. Reactions were assessed using the Brighton Collaboration case definition to identity potential anaphylaxis.ResultsWe obtained 10 case reports from various locations, with patients ranging in age from early-teens to adults. All patients had clinical or echocardiogram-obtained evidence of valvular disease. The majority of patients (80%) had received BPG prior to the event with no previous adverse reaction. In eight cases, the reaction was fatal; in one case resuscitation was successful and in one case treatment was not required. Only three cases met Level 1 Brighton criteria consistent with anaphylaxis.ConclusionThese results indicate that anaphylaxis is not a major cause of adverse reactions to BPG. An alternative mechanism for sudden death following BPG administration in people with severe RHD is proposed.

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