Isolated Rheumatic Pulmonary Valve Disease—Case Reports

Muthiah, Ramachandran

doi:10.4236/crcm.2016.56039

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Damage to the pulmonary valve caused by rheumatic fever is extremely rare, but this study showed involvement of the pulmonary valve in RHD, as pulmonary regurgitation, particularly in children more than in the young adult population; albeit being the least involved and always in combination with other valves. One study in India reported two cases of isolated pulmonary lesion of rheumatic origin in children under 15 years old (31) and one reported pulmonary valve involvement combined with other valves in 2.55% of cases in Nepal (19).…”

Section: Types Of Valvular Lesionsmentioning

confidence: 99%

Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

et al. 2020

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Introduction: Rheumatic heart disease (RHD) remains a major public health issue affecting children and young adults in developing countries. This study aimed to evaluate the clinical characteristics, management, and reactivation of RHD among children and young adults. Patients and Methods: This was a hospital-based retrospective study conducted at the National Cardiovascular Center Harapan Kita, Indonesia; we retrieved relevant data from patients diagnosed with RHD between 2012 and 2018. Results: Two hundred and seventy-nine patients were diagnosed with rheumatic heart disease, of whom 108 were children (mean age of 12.02 ± 3.36 years) and 171 were young adults (mean age was 24.9 ± 3.84). RHD was more common in female than in male young adults (1.5:1). Hospitalization due to RHD complications such as congestive heart failure was seen in 11.11% of cases in children, while pulmonary hypertension was present in 19.95% young adult cases. Reactivation of RHD occurred in 17.2% (48/279) cases, significantly in children (p < 0.001). Overall, the mitral valve (either isolated or combined) was the organ most affected in children (39.13%) and young adults (44.81%). Isolated mitral regurgitation was more common in children (13/21, 61.9%), while isolated mitral stenosis was more common in young adults (19/47, 40.42%). There was a high rate of rheumatic tricuspid valve disease in all populations (193/279, 69.17%) and reported involvement of pulmonary regurgitation (46/279, 16.48%). Multivalve lesions were more common than single lesions in both groups, with a combination of mitral and tricuspid regurgitation the predominant type in children (32/43, 74.41%) and mixed mitral lesion and tricuspid regurgitation in young adults (22/72, 30.56%). We observed a significant occurrence of quadrivalve lesions in children (p = 0.039). Valve repair was more common in children (49.07%) and replacement in young adults (32.16%), with low in-hospital mortality. Compliance with secondary prophylaxis was a significant challenge. Conclusion: Chronic RHD often presented with complications of the disease or reactivation of rheumatic fever (RF). Inadequate treatment of RF/RHD leads to extensive valvular damage and consequent disabilities. Efforts toward active early diagnosis and prompt treatment of RF/RHD and effective preventive measures are essential.

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Section: Types Of Valvular Lesionsmentioning

confidence: 99%

Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

et al. 2020

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“…Pulmonary valve stenosis caused by rheumatic disease is quite rare and, when it occurs, it is almost always accompanied by rheumatic lesions of other heart valves. A few cases of rheumatic pulmonary valve disease were reported in 2016 in children under the age of 15 in the tropical zone of India and most of them presented with various degrees of pulmonary stenosis without the involvement of other cardiac valves (3). Severe isolated primary rheumatic tricuspid and pulmonary insufficiency with normal left-side heart valves is extremely rare and almost always accompanied by endocarditis, carcinoid syndrome and trauma (4,5).…”

Section: Introductionmentioning

confidence: 99%

Case report: Surgical valvular pulmonary reconstruction for a previous unreported rheumatic right-sided valve disease with severe pulmonary regurgitation

Zhou

Tang

et al. 2023

Front. Cardiovasc. Med.

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Rheumatic heart disease (RHD) is a widespread illness in developing countries. RHD causes 99% of mitral stenoses in adults and 25% of aortic regurgitation. However, it only causes 10% of stenoses of the tricuspid valve, and is almost always associated with left-side valvular lesions. Isolated right-side valves are rarely affected, but may result in severe rheumatic pulmonary regurgitation. Herein, we present a case of rheumatic right-sided valve disease with severe pulmonary valve contracture and regurgitation in a symptomatic patient, successfully managed by surgical valvular reconstruction with a tailored bileaflet bovine pericardial patch. The options for surgical approach are also discussed. To our knowledge, the presented rheumatic right-sided valve disease with severe pulmonary regurgitation is the first to be reported in the literature.

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Acute Rheumatic Fever

Lahiri

Sanyahumbi

2021

Pediatrics in Review

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The incidence of acute rheumatic fever (ARF) is 8 to 51 per 100,000 people worldwide. It most commonly affects children 5 to 15 years of age after a group A streptococcal infection. Overcrowding and poor socioeconomic conditions are directly proportional to the incidence of ARF. Rheumatic carditis is a manifestation of ARF that may lead to rheumatic heart disease (RHD). Timely treatment of group A streptococcal infection can prevent ARF, and penicillin prophylaxis can prevent recurrence of ARF. Prevention of recurrent ARF is the most effective way to prevent RHD. ARF is diagnosed using the 2015 modified Jones criteria. There is no gold standard laboratory test. Therefore, clinicians need to be aware of the clinical signs and symptoms of ARF to include in their differential diagnosis when seeing such patients. Secondary prophylaxis with benzathine penicillin G has been shown to decrease the incidence of RHD and is key to RHD control. Clinicians need to understand the implications of secondary prophylaxis for ARF. There is also a need to improve ARF diagnosis, to find novel therapies to reduce the incidence of ARF, and to reduce the prevalence of RHD. RHD research is neglected and underfunded. Thus, there is also a need for RHD advocacy and public health awareness to increase research on RHD.

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Isolated Rheumatic Pulmonary Valve Disease—Case Reports

Cited by 3 publications

References 23 publications

Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

Clinical Profile and Management of Rheumatic Heart Disease in Children and Young Adults at a Tertiary Cardiac Center in Indonesia

Case report: Surgical valvular pulmonary reconstruction for a previous unreported rheumatic right-sided valve disease with severe pulmonary regurgitation

Acute Rheumatic Fever

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