Five cases of aortic incompetence and nodular seropositive rheumatoid arthritis are presented. Four cases underwent aortic valve replacement. Two of these had granulomatous involvement of the aortic cusps similar to subcutaneous rheumatoid nodules, and another showed a nonspecific fibrosis. One case had definite coincidental rheumatic aortic and mitral heart disease. Two patients had undergone ...

We herein report the case of a 68-year-old woman with a skin and soft tissue infection at her extremities. The blood culture results were positive for Streptococcus pyogenes, and we started treatment using ampicillin and clindamycin, although subsequent auscultation revealed a new-onset heart murmur. We therefore suspected rheumatic heart disease and infective endocarditis. The case met both th...

OBJECTIVES To investigate the role of pulmonary artery pressure (PAP) in predicting in-hospital death after valve replacement surgery in middle-aged and aged patients with rheumatic mitral disease. DESIGN An observational study. SETTING Guangdong General Hospital, China. PARTICIPANTS 1639middle-aged and aged patients (mean age 57±6 years) diagnosed with rheumatic mitral disease, undergoin...

Although cardiology was advancing rapidly in the 1950s it remained, like neurology, primarily a clinical discipline. Diagnosis relied on physical examination with some additional help from the electrocardiogram, chest X-ray and right heart catheterisation. Cardiac imaging was in its infancy. The specialty was led by some remarkable clinicians, notably Dr Paul Wood to whom I was house physician ...

The patient was a 19 year-old woman with the diagnosis of resistant hypertension, although she was under treatment of three classes of anti-hypertensive drugs (beta blocker, angiotensin receptor blocker, diuretic) for more than one year. In physical examination there was only a significant difference between the systolic blood pressure of upper and lower extremities (200 vs. 120 mmHg), without ...

To determine whether genetic factors could be involved in the pathogenesis of rheumatic heart disease, we performed HLA-A and HLA-B typing in 120 black patients with severe chronic rheumatic heart disease requiring cardiac surgery, and HLA-DR and HLA-DQ typing in 103 and 97 of these patients, respectively. The HLA typing was done by a standard microlymphocytotoxicity method. Patients were 12 to...

BACKGROUND Rheumatic Heart Disease (RHD), a chronic acquired heart disorder results from Acute Rheumatic Fever. It is a major public health concern in developing countries. In RHD, mostly the valves get affected. The present study investigated whether extracellular matrix remodelling in rheumatic valve leads to altered levels of collagen metabolism markers and if such markers can be clinically ...

A 46-year-old woman with a history of rheumatic heart disease and mitral and aortic valve replacement with mechanical bileaflet prosthesis was admitted with acute anterior wall ST-segment elevation myocardial infarction and cardiogenic shock after discontinuation of anticoagulant therapy. She underwent emergency coronary catheterization. Fluoroscopy confirmed normal motion of the prosthetic val...

Giant left atrium (GLA) is a well-described entity in association with rheumatic heart disease. However, mitral valve prolapse is an extremely unusual cause of GLA, especially without the compressive symptoms it can often accompany. We discuss a case of a 78-year-old lady with no prior history of rheumatic heart disease with these findings with the unusual presentation of accompanied unilateral...