Expression of the CD44 Protein in the Heart Valves Affected with Rheumatic Heart Disease

AbstractDuring any pregnancy there is an increase in blood volume of 30 to 50% resulting in increased pressure on the heart valves. For women with rheumatic heart disease this increased pressure presents increased maternal and/or fetal risks. Counseling of women with rheumatic heart disease gives appropriate surveillance of maternal and fetal well-being, as well as planning and documentation of the management of elective and emergency delivery. The care of pregnant women with rheumatic heart disease thus requires a multidisciplinary approach, involving obstetricians, cardiologists, and anesthetists. However, many women with rheumatic heart disease have healthy pregnancies and healthy babies with the right medical care.

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Multiple Large Atrial Thrombus Due To Rheumatic Heart Disease And Present Of Atrial Fibrillation With No Sign Of Stroke: How Is It Possible?

Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya ◽

10.30651/jqm.v3i2.2327 ◽

2019 ◽

Vol 3 (2) ◽

pp. 191

Author(s):

Ricky Indra Alfaray ◽

Deisha Laksmitha Ayomi ◽

Yan Efrata Sembiring

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Rheumatic Heart Disease ◽

Mitral Stenosis ◽

Left Atrial ◽

Heart Valves ◽

Brain Infarction ◽

Major Complication ◽

Atrial Thrombus ◽

Rheumatic Heart

ABSTRACT Atrial fibrillation is the most common arrhythmia associated with stroke and in the rheumatic heart disease patient’s atrial fibrillation can easily cause thromboembolism. Thromboembolism is the major complication also in patients of mitral stenosis with atrial fibrillation. A 54-year-old woman with uncontrollable movements in the right arm, stomach, right leg and painful swelling at right ankle joint was admitted to the emergency department. Transesophageal echocardiogram revealed rheumatic heart disease affecting two valves and thrombus in left atrial extending towards left atrial appendage. Heart rate was 120 beats per minute. ECG showed atrial fibrillation. A patient has undergone mitral and aortic valves replacement surgery and left atrial thrombus evacuation. Despite the involvement of two heart valves and the presence of large thrombus, the patient did not show any sign of brain infarction. This is a contradiction with a theory which implies that atrial fibrillation is the most common arrhythmia associated with stroke and in the rheumatic heart disease patient’s atrial fibrillation can easily cause thromboembolism and become stroke. This study evaluates many factors founded in the patient that make this anomaly may happen.Keywords : atrial fibrillation, rheumatic heart disease, thromboembolism strokeCorrespondence to : [email protected] Atrial fibrilasi merupakan jenis aritmia yang berkaitan erat dengan stroke dan cenderung menyebabkan thromboembolism. Thromboembolism merupakan komplikasi mayor dari mitral stenosis dengan atrial fibrilasi. Seorang wanita berusia 54 tahun masuk ke unit gawat darurat dengan keluhan utama gerakan tak terkendali pada lengan kanan, perut, kaki kanan, serta bengkak yang menyakitkan di sendi pergelangan kaki kanan. Echocardiogram transesophageal menunjukan gambaran penyakit jantung rematik pada dua katup dan trombus di atrium kiri meluas menuju valve atrium kiri. Detak jantung 120 kali per menit. EKG menunjukkan fibrilasi atrium. Pasien menjalani operasi penggantian katup mitral dan aorta serta evakuasi trombus pada atrium. Meskipun terdapat abnormalitas pada dua katup jantung ditambah dengan ditemukan adanya trombus besar pada atrium, pasien tidak menunjukkan tanda-tanda infark otak. Ini bertentangan dengan teori yang mengimplikasikan bahwa atrial fibrilasi adalah aritmia paling umum yang berhubungan dengan stroke dan pada penyakit jantung reumatik. Pasien dengan fibrilasi atrium dapat dengan mudah terjadi tromboemboli hingga bermanifestasi stroke. Studi ini mengevaluasi berbagai faktor yang memungkinkan anomali kasus seperti ini dapat terjadi.Kata kunci : fibrilasi atrium, penyakit jantung rematik, stroke thromboemboliKorespondensi : [email protected]

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Surgical options in rheumatic heart disease: an Indian surgeon’s perspective

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492319884797 ◽

2019 ◽

Vol 28 (7) ◽

pp. 371-373

Author(s):

Arkalgud Sampath Kumar

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Heart Valves ◽

Asian Countries ◽

Valve Repair ◽

The Past ◽

Surgical Options ◽

Mitral Valvotomy ◽

Delayed Referral ◽

Rheumatic Heart

Rheumatic heart disease is the primary cause of valvular heart disease in India and other Southeast Asian countries. The disease is quite different from that seen in France, USA, and Australia. Poverty, malnutrition, and delayed referral affect the outcomes. Rheumatic heart disease can affect all four heart valves, mitral being the most common, aortic second, tricuspid next, and finally the pulmonary valve. The combinations of mitral and aortic, mitral and tricuspid, and all three valves are the next in frequency. Acute rheumatic fever usually manifests as quadrivalvular involvement. However, chronic rheumatic quadrivalvular heart disease has also been reported. The technical aspects taught and practiced in one institution over the past four decades are described here. Closed mitral valvotomy, mitral valve repair, or replacement with mechanical, bioprosthetic, and autograft valves are the choices. Aortic valve disease is usually treated with valve repair or replacement with mechanical, homograft or pulmonary autograft valves.

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A case presentation on rheumatic heart disease with mitral regurgitation

Asian Pacific Journal of Nursing and Health Sciences ◽

10.46811/apjnh/1.1.3 ◽

2020 ◽

Vol 1 (01) ◽

Author(s):

Jayasudha A ◽

Sreerenjini B ◽

Kaveri P ◽

Anitha P

Keyword(s):

Heart Disease ◽

Mitral Regurgitation ◽

Rheumatic Heart Disease ◽

Heart Valves ◽

Well Being ◽

Case Presentation ◽

The Right ◽

Rheumatic Heart ◽

Increased Pressure ◽

In Pregnancy

In pregnancy there is increased pressure on the heart valves. Counseling of women with rheumatic heart disease gives appropriate surveillance of maternal and fetal well being, as well as planning and documentation of the management of elective and emergency delivery. However, many women with rheumatic heart disease have healthy pregnancies, healthy babies with the right medical care.

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The microvasculature of heart valves in rheumatic heart disease

American Heart Journal ◽

10.1016/0002-8703(72)90175-5 ◽

1972 ◽

Vol 84 (5) ◽

pp. 610-619 ◽

Cited By ~ 3

Author(s):

Geoffrey Farrer-Brown ◽

M.H. Tarbit

Keyword(s):

Heart Disease ◽

Rheumatic Heart Disease ◽

Heart Valves ◽

Rheumatic Heart

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Microbiota in Gut, Oral Cavity, and Mitral Valves Are Associated With Rheumatic Heart Disease

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.643092 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xue-Rui Shi ◽

Bo-Yan Chen ◽

Wen-Zhen Lin ◽

Yu-Lin Li ◽

Yong-Li Wang ◽

...

Keyword(s):

Heart Disease ◽

Oral Cavity ◽

Rheumatic Heart Disease ◽

Heart Valves ◽

16S Rrna Gene Sequencing ◽

Autoimmune Response ◽

Rrna Gene ◽

Mitral Valves ◽

Control Subjects ◽

Rheumatic Heart

Rheumatic heart disease refers to the long-term damage of heart valves and results from an autoimmune response to group A Streptococcus infection. This study aimed to analyze the microbiota composition of patients with rheumatic heart disease and explore potential function of microbiota in this disease. First, we revealed significant alterations of microbiota in feces, subgingival plaques, and saliva of the patients compared to control subjects using 16S rRNA gene sequencing. Significantly different microbial diversity was observed in all three types of samples between the patients and control subjects. In the gut, the patients possessed higher levels of genera including Bifidobacterium and Eubacterium, and lower levels of genera including Lachnospira, Bacteroides, and Faecalibacterium. Coprococcus was identified as a super-generalist in fecal samples of the patients. Significant alterations were also observed in microbiota of subgingival plaques and saliva of the patients compared to control subjects. Second, we analyzed microbiota in mitral valves of the patients and identified microbes that could potentially transmit from the gut or oral cavity to heart valves, including Streptococcus. Third, we further analyzed the data using random forest model and demonstrated that microbiota in the gut, subgingival plaque or saliva could distinguish the patients from control subjects. Finally, we identified gut/oral microbes that significantly correlated with clinical indices of rheumatic heart disease. In conclusion, patients with rheumatic heart disease manifested important alterations in microbiota that might distinguish the patients from control subjects and correlated with severity of this disease.

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