A review on lupus disease, symptoms and their treatment with traditional medicines

Lupus erythematous is an autoimmune illness that mostly affects women and has no recognized cause. The classical period, the neoclassical period and the modern period are the three periods in the history of lupus erythematous. Important discoveries have occurred at each period allowing for a better understanding of a conditions.Pericarditis, valvular lesions and myocardial dysfunction, particularly mild pericarditis. As a result, echocardiography should be done on SLE patients on a regular basis. Vascular blockage, including coronary arteries can occur as a result of SLE related vasculitis early atherosclerosis or antiphospholipid antibodies. The immune system of the body becomes overactive and targets normal, healthy tissue. Inflammation, swelling and damage to the skin, joints, skin, kidney, blood, heart, and lungs are among the symptoms and medicinal treatment commonly used with the help of ayurvedic treatment, allopathic treatment and homeopathic treatment.

Pediatric Behcet's Disease Patient with Cardiac Valvular Lesions: case report and a review of the literature

Background To explore the clinical characteristics, treatment regimen, and prognosis of cardiac valvular involvement in pediatric Behcet's disease. Methods Retrospective analysis was conducted on the clinical data obtained from one pediatric patient suffering from Behcet's disease with cardiac valvular involvement. Present study also reviewed the literature related to cardiac involvement in pediatric Behcet's disease. Results The disease onset in the female patient was reported at the age of 3 years, with clinical symptoms, including apthous ulcers, fever, perianal ulcers, and erythema nodosum, accompanied by a significant increase in the inflammatory markers. Echocardiography indicated that aortic valve (AV) lesions, which were absent initially, developed later, gradually exacerbated. Initially, she was diagnosed as "infectious disease" and "systemic inflammatory response syndrome", and antibiotic therapy proved ineffective. After an accurate diagnosis of Behcet's disease, the patient was given glucocorticoids, immunosuppressants, and biologics, which resulted in the relief of the symptoms; however, cardiac valvular lesions continued to exacerbate. Subsequent treatment included medical treatment and surgical treatment, and the patient's condition was stable at follow-up. Conclusions Cardiac valvular lesions in pediatric Behcet's disease are rare with insidious onset, enhancing the propensity of misdiagnosis or missed diagnosis. Main manifestations include recurrent oral ulceration, skin lesions, and fever. Cardiac involvement may occur early, yet the symptoms are insidious, requiring comprehensive physical examination and close monitoring of echocardiography. Glucocorticoids combined with immunosuppressants are the primary therapy for cardiac involvement in Behcet's disease. When cardiac valvular damage and dysfunction are observed, treatment regimens can be jointly recommended by multidisciplinary consultation to conduct the surgical treatment on time.

Tricuspid chordal rupture following stab injury: a case of successful repair

We report a case of a 32-year-old male patient who sustained an isolated stab injury to the left chest wall. He was initially treated with emergency surgery for right ventricular free wall rupture, with an uneventful postoperative course. During follow-up, the patient complained of exercise intolerance and dyspnea on effort. Transthoracic echocardiography (TTE) demonstrated a previously undiagnosed severe tricuspid regurgitation due to flail of the anterior leaflet and a ruptured chorda. A redo operation was scheduled, and the valve was successfully repaired, with different techniques employed. This case highlights the importance of careful clinical evaluation of victims of chest penetrating trauma and how early diagnosis of hidden valvular lesions might increase the odds of valve repair. It also demonstrates the clover technique as a valuable technique in the correction of traumatic tricuspid regurgitation.

A Rare Case report on Rheumatic Origin of Severe Tricuspid stenosis

Tricuspid stenosis is a very rare valvular disease due to narrowing of the orifice of the tricuspid valve of the heart. It is usually of rheumatic origin which is accompanied by other valvular lesions. Other causes of tricuspid stenosis include carcinoid syndrome, endocarditis, endomyocardial fibrosis, lupus erythematosus, right atrial myxoma, drug induced and congenital tricuspid atresia. Here we report a patient who had undergone percutaneous transluminal mitral commissurotomy (PTMC) followed by mitral restenosis with Severe Tricuspid Stenosis with Severe Tricuspid Regurgitation.

Variation in management of paediatric isolated bicuspid aortic valve: current practice survey

Background: Prior to the recent release of appropriate use criteria for imaging valvulopathies in children, follow-up of valvular lesions, including isolated bicuspid aortic valve, was not standardised. We describe current follow up, treatment, and intervention strategies for isolated bicuspid aortic valve with varying degrees of stenosis, regurgitation, and dilation in children up to 18 years old and compare them with newly released appropriate use criteria. Methods: Online survey was sent to members of the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and PediHeartNet. Results: Totally, 106 responses with interpretable data were received. For asymptomatic patients with isolated BAV without stenosis, regurgitation, or dilation follow-up-intervals increased from 7+/−4 months in the newborn period to 28 +/− 14 months at 18 years of age. Respondents recommended more frequent follow-up for younger patients and those with greater disease severity. More than 80% of respondents treat aortic regurgitation or aortic dilation in the setting of bicuspid aortic valve medically. In general, intervention was recommended once stenosis or regurgitation became severe (stenosis of >4 m/s; regurgitation with LV Z score 4) regardless of age, but was not routinely recommended for younger children (newborn – age 6 years) with severe dilation. Exercise was restricted at 38+/−11 mmHg echocardiographic mean gradient. Conclusions: Current follow-up, treatment, and intervention strategies for isolated bicuspid aortic valve deviate from appropriate use criteria. Differences between the two highlight the need to better delineate the disease course, clarify recommendations for care, and encourage wider adoption of guidelines.

Preoperative false-negative transthoracic echocardiographic results in native valve infective endocarditis patients: a retrospective study from 2001 to 2018

Background Infective endocarditis (IE) is a lethal disease that is difficult to diagnosis early. Although echocardiography is one of the most widely used diagnostic technique, it has limited sensitivity. This study surveyed the clinical features of IE patients who underwent surgery and compared transthoracic echocardiography and histological findings to explore the factors related to false-negative echocardiographic results. Methods Medical records were extracted from IE patients consecutively hospitalized between June 2001 and June 2018. Results A total of 182 patients with native valve IE who underwent surgery were included. Compared to the non-surgery group, the surgery group was more likely to have pre-existing valvular lesions and more serious cardiac conditions and a relative lack of signs of infection and cerebrovascular events, leading to a lower proportion of “definite cases” before surgery. The false-negative rate of echocardiography was 14.5%. Echocardiography has significant disadvantages in diagnosing perivalvular abscesses, valve perforations, and left-sided endocarditis, especially for subjects with both aortic and mitral valve infections. The multivariate analysis identified congenital heart disease and small vegetations (< 10 mm) as independent predictors of false-negative echocardiography results. Conversely, fever and heart murmurs on admission served as protective factors. Conclusions Under some circumstances, echocardiography provides inconsistent results compared with surgical findings, and negative echocardiography results do not rule out IE. The diagnosis of IE depends on comprehensive evaluations using multiple methods.

Preoperative false-negative transthoracic echocardiographic results in native valve infective endocarditis patients: a retrospective study from 2001 to 2018

Background: Infective endocarditis (IE) is a lethal disease that is difficult to diagnosis early. Although echocardiography is one of the most widely used diagnostic technique, it has limited sensitivity. This study surveyed the clinical features of IE patients who underwent surgery and compared transthoracic echocardiography and histological findings to explore the factors related to false-negative echocardiographic results.Methods: Medical records were extracted from IE patients consecutively hospitalized between June 2001 and June 2018. Results: A total of 182 patients with native valve IE who underwent surgery were included. Compared to the non-surgery group, the surgery group was more likely to have pre-existing valvular lesions and more serious cardiac conditions and a relative lack of signs of infection and cerebrovascular events, leading to a lower proportion of “definite cases” before surgery. The false-negative rate of echocardiography was 14.5%. Echocardiography has significant disadvantages in diagnosing perivalvular abscesses, valve perforations, and left-sided endocarditis, especially for subjects with both aortic and mitral valve infections. The multivariate analysis identified congenital heart disease and small vegetations (<10 mm) as independent predictors of false-negative echocardiography results. Conversely, fever and heart murmurs on admission served as protective factors. Conclusions: Under some circumstances, echocardiography provides inconsistent results compared with surgical findings, and negative echocardiography results do not rule out IE. The diagnosis of IE depends on comprehensive evaluations using multiple methods.

Valvular lesions and Epilepsy, Khartoum, Sudan 2018

Introduction: Epilepsy is either; idiopathic when there is no underlying cause or secondary if there is an underlying cause of egg brain tumors, stroke. There is a strong in conjunction between epilepsy and valvular lesions. Objective: To study the relationship between valvular lesions and Epilepsy among Sudanese epileptic patients. Methodology: Almost 50 Sudanese patients with valvular lesions were included in the study during Jane 2018 to Jane 2019. Result: Out of 50 patients (48%) males while females (52%). Almost 40% of the patients were found to have generalized tonic colonic epilepsy, while 60% have focal epilepsy. Pure MS was the common valvular lesion observed. 14% of the patients had atrial fibrillation, especially with mitral stenosis .4% of the patients underwent valvotomy. Abnormal EEG was observed in 64% of the patients. Abnormal brain MRI was detected in 50% of the patients. Almost all the patients 100% diagnosed as having valvular lesions before being diagnosed with epilepsy. Conclusion: There is a strong relationship between valvular lesions and epilepsy, most probably due to association with coexist arrhythmias resulting in cerebral infarction, tight valvular lesions, and rarely follow valvotomy valvular replacement.

Preoperative false-negative transthoracic echocardiographic results in native valve infective endocarditis patients: a retrospective study from 2001 to 2018

Background: Infective endocarditis (IE) is a lethal disease that is difficult to diagnosis early. Although echocardiography is one of the most widely used diagnostic technique, it has limited sensitivity. This study surveyed the clinical features of IE patients who underwent surgery and compared transthoracic echocardiography and histological findings to explore the factors related to false-negative echocardiographic results.Methods: Medical records were extracted from IE patients consecutively hospitalized between June 2001 and June 2018.Results: A total of 182 patients with native valve IE who underwent surgery were included. Compared to the non-surgery group, the surgery group was more likely to have pre-existing valvular lesions and more serious cardiac conditions and a relative lack of signs of infection and cerebrovascular events, leading to a lower proportion of “definite cases” before surgery. The false-negative rate of echocardiography was 14.5%. Echocardiography has significant disadvantages in diagnosing perivalvular abscesses, valve perforations, and left-sided endocarditis, especially for subjects with both aortic and mitral valve infections. The multivariate analysis identified congenital heart disease and small vegetations (<10 mm) as independent predictors of false-negative echocardiography results. Conversely, fever and heart murmurs on admission served as protective factors.Conclusions: Under some circumstances, echocardiography provides inconsistent results compared with surgical findings, and negative echocardiography results do not rule out IE. The diagnosis of IE depends on comprehensive evaluations using multiple methods.