Acute Rheumatic Fever and Rheumatic Heart Disease

Book
Copyright_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart-Disease
	Copyright
Professor-Bongani-Mbawethu-Ma_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart
	Professor Bongani Mbawethu Mayosi
Professor-Diana--Dinny--Len_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart-D
	Professor Diana (Dinny) Lennon
List-of-Contributors_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart-Disease
	List of Contributors
Preface_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart-Disease
	Preface
Front-Matter_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart-Disease
	Acute Rheumatic Fever and Rheumatic Heart Disease
Chapter-1---Epidemiology--Risk-Factors--Burden-an_2021_Acute-Rheumatic-Fever
	1. Epidemiology, Risk Factors, Burden and Cost of Acute Rheumatic Fever and Rheumatic Heart Disease
		INTRODUCTION
		EPIDEMIOLOGY OF ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
			Incidence of Acute Rheumatic Fever
			Prevalence of Rheumatic Heart Disease
			Heart Failure due to Rheumatic Heart Disease
			Excess Mortality from Rheumatic Heart Disease
		RISK FACTORS FOR ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
			Pathogen and Host Factors that Lead to Acute Rheumatic Fever and Rheumatic Heart Disease
				Factors specific to the streptococcal organism
				Host demographics
				Host genetic factors
				Host oral health status
				Host nutritional status
			Social and Environmental Conditions
				Household crowding, including bed sharing
				Household resources, including washing and laundry
				Housing conditions, including tenure, damp, and cold
				Healthcare utilization and health literacy
			Summary of Risk and Protective Factors for Acute Rheumatic Fever and Rheumatic Heart Disease
		MEASURES OF GLOBAL DISEASE BURDEN
		ECONOMIC CONSEQUENCES OF ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
		REFERENCES
Chapter-2---Pathogenesis-of-Acute-R_2021_Acute-Rheumatic-Fever-and-Rheumatic
	2. Pathogenesis of Acute Rheumatic Fever
		INTRODUCTION
		OVERVIEW OF THE PATHOGENESIS OF ACUTE RHEUMATIC FEVER
		MEDIATORS OF AUTOIMMUNE REACTIONS
		MOLECULAR MIMICRY
		CARDITIS AND RHEUMATIC HEART DISEASE
		T CELLS AND RHEUMATIC HEART DISEASE
		SYDENHAM CHOREA
		GENETIC SUSCEPTIBILITY TO ACUTE RHEUMATIC FEVER
		REFERENCES
Chapter-3---Clinical-Evaluation-and-Diagno_2021_Acute-Rheumatic-Fever-and-Rh
	3. Clinical Evaluation and Diagnosis of Acute Rheumatic Fever
		INTRODUCTION
		CLINICAL EVALUATION OF ACUTE RHEUMATIC FEVER
			Risk Factors for Acute Rheumatic Fever
		CLINICAL FEATURES OF ACUTE RHEUMATIC FEVER
			Major Manifestations
				Joint symptoms (arthritis and arthralgia)
				Carditis
				Chorea
				Erythema Marginatum
				Subcutaneous Nodules
			Minor Manifestations
				Fever
				Arthralgia
				Elevated Acute Phase Reactants
				First-Degree Heart Block
		OTHER CLINICAL MANIFESTATIONS OF ACUTE RHEUMATIC FEVER
		DIAGNOSTIC INVESTIGATIONS FOR ACUTE RHEUMATIC FEVER
			Laboratory Evidence of a Preceding Group A Streptococcus Infection
				Throat Culture
				Rapid Antigen Detection Testing
				Streptococcal Serology
			Chest X-ray
			Echocardiography
			Diagnosis of Rheumatic Carditis by Echocardiography
		DIAGNOSIS OF ACUTE RHEUMATIC FEVER
		RATIONALE FOR 2015 REVISION
			Possible Acute Rheumatic Fever
			Rheumatic Fever Recurrences
		INTERNATIONAL DIAGNOSTIC CRITERIA (AUSTRALIA, NEW ZEALAND, BRAZIL, INDIA)3,4,78,79
		DIFFERENTIAL DIAGNOSIS OF ACUTE RHEUMATIC FEVER
		FUTURE RESEARCH DIRECTIONS
			Working toward Universal Diagnostic Criteria
			The Search for a Molecular Signature in the Diagnosis of Acute Rheumatic Fever
			More Appropriate Ways of Diagnosing Acute Rheumatic Fever in the 21st Century
		REFERENCES
Chapter-4---Management-of-Acute-Rhe_2021_Acute-Rheumatic-Fever-and-Rheumatic
	4. Management of Acute Rheumatic Fever
		INTRODUCTION
		ESTABLISHING THE DIAGNOSIS
		ERADICATION OF THE GROUP A STREPTOCOCCUS
		GENERAL MEASURES AND SYMPTOMATIC RELIEF
			Fever
			Bed Rest and Diet
		MAJOR MANIFESTATIONS
			Arthritis and/or Arthralgia
			Carditis and Heart Failure
				Carditis
				Advanced atrioventricular block
				Heart failure
					Heart-failure medications
					Heart-failure medications
					Antiinflammatory medications
					Antiinflammatory medications
					Heart valve surgery
					Heart valve surgery
			Sydenham Chorea
		DISCHARGE PROTOCOL
			Discharge Criteria
			Notification
			Patient and Family Education
			Prophylaxis
				Infective endocarditis
			Outpatient Follow-up
		REFERENCES
Chapter-5---Clinical-Evaluation-and-Diagno_2021_Acute-Rheumatic-Fever-and-Rh
	5. Clinical Evaluation and Diagnosis of Rheumatic Heart Disease
		INTRODUCTION
		EPIDEMIOLOGY OF RHEUMATIC HEART DISEASE
		DIAGNOSTIC CRITERIA FOR RHEUMATIC HEART DISEASE
			Diagnosis of Chronic Rheumatic Heart Disease in Individuals with a History of Acute Rheumatic Fever
			Diagnosis of Rheumatic Heart Disease in Individuals Without a History of Acute Rheumatic Fever
		CLINICAL ASSESSMENT AND FINDINGS
			Innocent Cardiac Murmurs
				Innocent murmurs in the pediatric population
			Pathological Murmurs in the Pediatric Population
			Pathological Murmurs in the Adult Population
			Mitral Regurgitation
				Clinical symptoms
				Clinical signs: mild-to-moderate mitral regurgitation
				Clinical signs: moderate-to-severe mitral regurgitation
				Electrocardiogram
				Chest X-ray
			Mitral Stenosis
				Clinical symptoms
				Clinical signs: mild to moderate
				Clinical signs: moderate to severe
				Electrocardiogram
				Chest X-ray
			Mixed Mitral Valve Disease
				Clinical symptoms
				Clinical signs: moderate to severe
				Electrocardiogram
				Chest X-ray
			Aortic Regurgitation
				Clinical symptoms
				Clinical signs: mild-to-moderate aortic regurgitation
				Clinical signs: moderate-to-severe aortic regurgitation
				Electrocardiogram
				Chest X-ray
			Aortic Stenosis
				Clinical symptoms
				Clinical signs: mild to moderate
				Clinical signs: moderate to severe
				Electrocardiogram
				Chest X-ray
			Tricuspid Regurgitation
				Clinical symptoms
				Clinical signs: mild to moderate
				Clinical signs: moderate to severe
				Electrocardiogram
				Chest X-ray
			Pulmonary Regurgitation
				Clinical symptoms
				Clinical signs: mild to moderate
				Clinical signs: moderate to severe
				ECG
				Chest X-ray
			Multivalve Rheumatic Heart Disease
				Clinical symptoms
				Clinical signs: severe multivalve disease
				ECG
				Chest X-ray
		ECHOCARDIOGRAPHY IN RHEUMATIC HEART DISEASE
			Grading the Severity of Valve Disease Using Echocardiography
			Mitral Valve Disease
				Echocardiography of isolated mitral regurgitation
				Echocardiographic findings in isolated mitral stenosis
				Echocardiography in mixed mitral valve disease
			Aortic Valve Disease
			Tricuspid Valve Disease
			Pulmonary Valve Disease
			Evaluation of Prosthetic Valves
			Monitoring Disease Progression and Resolution
			Guide to Nature and Timing of Cardiosurgical Intervention
			3D Echocardiography and Rheumatic Valve Disease
		OTHER IMAGING AND DIAGNOSTIC MODALITIES
			Cardiac Catheterization
			Computed Tomography
			Cardiac Magnetic Resonance Imaging
		EVALUATION OF HEART FAILURE
			Clinical Investigations for Chronic Heart Failure
				Full blood count
				Electrolytes and renal function testing
				Troponin
				Liver function testing and clotting profile
				Inflammatory markers
				Antibody testing
				Biomarkers for heart failure
			Exercise Stress Testing
		DISEASE PROGRESSION AND NATURAL HISTORY
		FUTURE DIRECTIONS
		REFERENCES
Chapter-6---Medical-Management-of-Rheu_2021_Acute-Rheumatic-Fever-and-Rheuma
	6. Medical Management of Rheumatic Heart Disease
		INTRODUCTION
		PRINCIPLES OF MANAGEMENT OF RHEUMATIC HEART DISEASE
		MEDICAL MANAGEMENT OF CHRONIC HEART FAILURE IN RHEUMATIC HEART DISEASE
			Overview of Heart Failure Treatment
			Heart Failure Managment (HFrEF)
				General management
				Pharmacological therapy
		MEDICAL MANAGEMENT OF INDIVIDUAL VALVE LESIONS
			Chronic Mitral Regurgitation
				Natural History and Pathophysiology of Mitral Regurgitation
				Mitral Regurgitation Medical Management
				Indications for Cardiac Surgery for Mitral Regurgitation
					Serial evaluation
					Serial evaluation
		MITRAL STENOSIS
			Natural History and Pathophysiology of Mitral Stenosis
			Medical Management of Mitral Stenosis
			Indications for Percutaneous Mitral Balloon Commissurotomy and Cardiac Surgery
				Serial evaluation
		CHRONIC AORTIC REGURGITATION
			Natural History and Pathophysiology of Aortic Regurgitation
			Medical Management of Chronic Aortic Regurgitation
			Indications for Cardiac Surgery in Chronic Aortic Regurgitation
				Serial evaluation
		AORTIC STENOSIS
			Natural History and Pathophysiology of Aortic Stenosis
			Medical Management of Aortic Stenosis
			Indications for Surgery in Aortic Stenosis
				Transcatheter Aortic Valve Implantation
				Serial evaluation
		OTHER CHRONIC RHEUMATIC HEART DISEASE ENTITIES
			Multivalve Disease and Mixed Valve Disease
			Tricuspid Valve Disease
			Prosthetic Valve Patients
				Mechanical valves
				Bioprosthetic valves
		GENERAL CARE PRINCIPALS FOR THE RHD PATIENT
			Secondary Prevention With Antibiotic Prophylaxis
			Antithrombotic Therapy in Rheumatic Heart Disease
				Antithrombotic Therapy for Prosthetic Valves
				Anticoagulation in Atrial Fibrillation
					Initiating warfarin therapy
					Initiating warfarin therapy
				Anticoagulation for patients in sinus rhythm and who have not had valve surgery
			Access to oral healthcare
			Infective Endocarditis Prophylaxis
		REFERENCES
Chapter-7---Catheter-Based-Evaluation-and-T_2021_Acute-Rheumatic-Fever-and-R
	7. Catheter-Based Evaluation and Treatment of Rheumatic Heart Disease
		INTRODUCTION
		INDICATIONS FOR CATHETER-BASED EVALUATION IN THE PATIENT WITH RHEUMATIC HEART DISEASE
		MEASUREMENTS IN THE CATHETERIZATION LABORATORY
			Basics of Cardiac Catheterization and Pressure Measurement
			Contour of Normal Pressure Waveforms and Common Artifacts
			Estimation of Pulmonary Capillary Wedge Pressure
			Estimation of Cardiac Output
		HEMODYNAMIC ASSESSMENT OF VALVE FUNCTION
			Mitral Stenosis
				The hemodynamic findings of mitral stenosis at cardiac catheterization
				Quantification of severity of mitral stenosis and calculation of valve area
			Mitral Regurgitation
				The hemodynamic findings in rheumatic mitral regurgitation at cardiac catheterization
			Mixed Mitral Valve Disease
			Aortic Valve Disease
				Aortic Stenosis
				Aortic Regurgitation
			Tricuspid Valve Disease
		CATHETHER-BASED INTERVENTIONS IN RHEUMATIC HEART DISEASE
			Mitral Stenosis
				Percutaneous mitral balloon commissurotomy
					Indications for Percutaneous Mitral Balloon Commissurotomy
					Indications for Percutaneous Mitral Balloon Commissurotomy
					Percutaneous Mitral Balloon Commissurotomy Technique
					Percutaneous Mitral Balloon Commissurotomy Technique
					Complications of Percutaneous Mitral Balloon Commissurotomy
					Complications of Percutaneous Mitral Balloon Commissurotomy
					Outcomes Following Percutaneous Mitral Balloon Commissurotomy
					Outcomes Following Percutaneous Mitral Balloon Commissurotomy
			Interventions in Rheumatic Aortic Valve Disease
		CONCLUSION
		REFERENCES
Chapter-8---Surgical-Management-of-Rheuma_2021_Acute-Rheumatic-Fever-and-Rhe
	8. Surgical Management of Rheumatic Valvular Heart Disease
		INTRODUCTION
		HISTORICAL BACKGROUND
		ANATOMICAL FEATURES AND CLINICAL SPECTRUM OF SURGICAL RHEUMATIC HEART DISEASE
			Mitral Valve Disease
			Aortic Valve Disease
			Tricuspid Valve Disease
		PREOPERATIVE DIAGNOSTIC WORK-UP
			Echocardiography—What Are Surgeons Looking for?
				Mitral valve analysis
				Aortic valve analysis
				Tricuspid valve analysis
					Role of the preoperative three-dimensional and transesophageal echocardiogram
					Role of the preoperative three-dimensional and transesophageal echocardiogram
			Left and Right Catheterization—Coronary Angiography
			New Methods—CT Scan and Magnetic Resonance Imaging
		INDICATIONS FOR SURGERY AND SURGICAL TECHNIQUES
			The Young Rheumatic Patient
				Closed mitral commissurotomy for mitral stenosis
				Open mitral commissurotomy for mitral stenosis
				Repair for mitral valve regurgitation
				Mitral valve replacement
					Selection of valve prosthesis
					Selection of valve prosthesis
					Technique of valve replacement
					Technique of valve replacement
				Surgery for aortic valve disease
					Aortic valve repair
					Aortic valve repair
					Aortic valve replacement
					Aortic valve replacement
				Tricuspid valve disease
					Tricuspid regurgitation
					Tricuspid regurgitation
					Tricuspid stenosis
					Tricuspid stenosis
				Multi valve surgery
		EARLY AND LONG-TERM OUTCOMES OF RHEUMATIC VALVE SURGERY
			Perioperative Results
			Long-Term Outcomes: Repair Versus Replacement
				Mitral valve
				Aortic valve
			How Far Can We Go With Repair?
		THE ROLE OF NEW TECHNOLOGIES
		CONCLUSIONS AND RECOMMENDATIONS
		REFERENCES
Chapter-9---Rheumatic-Heart-Disease_2021_Acute-Rheumatic-Fever-and-Rheumatic
	9. Rheumatic Heart Disease in Pregnancy
		INTRODUCTION
		EPIDEMIOLOGY OF RHEUMATIC HEART DISEASE IN PREGNANCY
		MATERNAL CARDIAC PHYSIOLOGY
		PRECONCEPTION EVALUATION
			Risk Stratification
				Mitral Stenosis
				Aortic Stenosis
				Mitral and Aortic Regurgitation
				Tricuspid Regurgitation
				Mixed Valve Lesions
				Mitral/Aortic Valve Replacement
					Bioprosthetic Valves
					Bioprosthetic Valves
					Mechanical valves
					Mechanical valves
		CLINICAL EVALUATION DURING NORMAL PREGNANCY
		MANAGEMENT OF RHEUMATIC HEART DISEASE IN PREGNANCY
			Management of Heart Failure in Pregnancy
			Management of Specific Valve Lesions During and Before Pregnancy
				Mitral Stenosis
				Mitral and Aortic Regurgitation
				Aortic Stenosis
			Anticoagulation in Pregnancy
				Anticoagulation for Mechanical Prostheses
					Vitamin K Antagonists
					Vitamin K Antagonists
					Heparins
					Heparins
				Emergency Reversal of Anticoagulation
			Labor and Delivery
		CONTRACEPTIVE CHOICES IN WOMEN WITH RHEUMATIC HEART DISEASE
			Contraceptive Methods
				Progestogen-only methods
				Copper IUD
				Emergency contraception
		CONCLUSION
		REFERENCES
Chapter-10---Primary-Prevention-of-Acute-Rheu_2021_Acute-Rheumatic-Fever-and
	10. Primary Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease
		PRIMORDIAL PREVENTION
		EFFECTIVENESS OF PRIMARY PREVENTION
		DIAGNOSIS OF GROUP A STREPTOCOCCAL PHARYNGITIS
			Streptococcal Antibody Tests
		TREATMENT OF GROUP A STREPTOCOCCAL PHARYNGITIS
			Delivery of Benzathine Penicillin G: Barriers and Potential Solutions
			Safe Administration of Benzathine Penicillin G
			Future Directions in the Treatment of Group A Streptococcal Infections
		COST-EFFECTIVENESS OF PRIMARY PREVENTION
		DELIVERY OF PRIMARY PREVENTION STRATEGIES
			Population-Based Strategies
			Health System-Based Strategies
		CONCLUSION
		REFERENCES
Chapter-11---Secondary-Prevention-of-Acute-Rh_2021_Acute-Rheumatic-Fever-and
	11. Secondary Prevention of Acute Rheumatic Fever and Rheumatic Heart Disease
		INTRODUCTION
			Definition of Secondary Prevention
			Historical Background
			Evidence of Effectiveness
			Limitations and Challenges in Delivery of Secondary Prophylaxis
		PENICILLIN FOR SECONDARY PROPHYLAXIS
			Penicillins and Pharmacokinetics
			Penicillin Supply
			Penicillin Adverse Reactions
		CLINICAL EVALUATION AND MANAGEMENT OF ANAPHYLAXIS
			Definition and Diagnosis
			Management of anaphylaxis
				Assessment of possible penicillin allergy
		SECONDARY PROPHYLAXIS RECOMMENDATIONS AND REGIMENS
			Antibiotic Dosing and Frequency
			Duration of Secondary Prophylaxis
			Stopping Secondary Prophylaxis
		IMPROVING ADHERENCE TO SECONDARY PROPHYLAXIS
			Reasons for Nonadherence
			Methods to Support Adherence
		PROGRAMMATIC APPROACHES TO SECONDARY PROPHYLAXIS DELIVERY
		INDIVIDUAL APPROACHES TO SECONDARY PROPHYLAXIS DELIVERY
		REDUCING THE PAIN OF BENZATHINE PENICILLIN G INJECTIONS
			Procedure for Preparation and Delivery of Benzathine Penicillin G Injection With Lidocaine
				Addition of 2% lidocaine to benzathine penicillin G pre-filled syringe
		ADMINISTERING THE INTRAMUSCULAR INJECTION
		SECONDARY PROPHYLAXIS IN SPECIAL CIRCUMSTANCES
			Secondary Prophylaxis During Pregnancy
			Secondary Prophylaxis while Breastfeeding
			Secondary Prophylaxis while on Oral Contraceptive
			Secondary Prophylaxis in Anticoagulated Patients
		REFERENCES
Chapter-12---Rheumatic-Heart-Disease-Control-_2021_Acute-Rheumatic-Fever-and
	12. Rheumatic Heart Disease Control Programs, Registers, and Access to Care
		RHEUMATIC HEART DISEASE CONTROL PROGRAMS
			1900 – 1950s
			1950s–2000
			2000–2005
			2005–2018
				Contemporary recommendations for RHD control programs
		INTRODUCTION TO DISEASE REGISTERS WITH A FOCUS ON RHEUMATIC HEART DISEASE
			Introduction to Registers
			Issues Specific to Rheumatic Heart Disease Registers
		ACCESS TO CARE
		CONCLUSION
		REFERENCES
Chapter-13---Echocardiographic-Screening-_2021_Acute-Rheumatic-Fever-and-Rhe
	13. Echocardiographic Screening for Rheumatic Heart Disease
		INTRODUCTION
		THE RATIONALE FOR RHEUMATIC HEART DISEASE SCREENING
		THE EVOLUTION OF RHEUMATIC HEART DISEASE SCREENING
			Terminology
			Accuracy of Auscultation for Rheumatic Heart Disease
			Standardization of Echocardiographic Criteria
			Technical Considerations and Interpretation of the Guidelines
		CONTRIBUTION OF ECHOCARDIOGRAPHIC SCREENING FOR RHEUMATIC HEART DISEASE EPIDEMIOLOGY
		INNOVATIONS IN ECHOCARDIOGRAPHIC SCREENING
			Screening by Nonexpert Operators
			Innovative Technologies for Screening
			Abbreviated Protocols and Agreed Cut-Off Points
			Training Procedures
		FUTURE DIRECTIONS AND UNANSWERED QUESTIONS
			Disease Progression of Latent (Subclinical) Rheumatic Heart Disease
			Does Identification of Latent Rheumatic Heart Disease Improve Outcomes?
			Is Echocardiographic Screening Cost-Effective in Low Resource Areas?
			What Would it Take to Scale-Up Echocardiographic Screening to a National/Global Level?
			What are the Harms of a Screening Program?
			What is the Ideal Model/Test Strategy for Echocardiographic Screening?
		CONCLUSIONS
		REFERENCES
Chapter-14---Group-A-Streptococcu_2021_Acute-Rheumatic-Fever-and-Rheumatic-H
	14. Group A Streptococcus Vaccines
		INTRODUCTION
		ISSUES IN GAS VACCINE DEVELOPMENT
		HISTORY OF GAS VACCINES
		21ST CENTURY GAS VACCINE DEVELOPMENT
			M-protein Vaccines
			Non-M-protein Vaccines
		FUTURE DEVELOPMENT ACTIVITIES
		REFERENCES
Chapter-15---Awareness--Education--_2021_Acute-Rheumatic-Fever-and-Rheumatic
	15. Awareness, Education, and Advocacy
		INTRODUCTION
		BASELINE AWARENESS
			Community
			Teachers
			People and Families Living with Acute Rheumatic Fever and Rheumatic Heart Disease
			Clinicians
			Policy Makers and Funders
		INTERVENTIONS TO IMPROVE AWARENESS
		MOVING FROM ORGANIC TO STRATEGIC APPROACHES
		LOCAL AND GLOBAL ADVOCACY EFFORTS
			Defining Advocacy
			What Can Be Achieved Through Successful Advocacy in Rheumatic Heart Disease?
			Moving the Needle
		WHAT NEXT FOR ACUTE RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE?
		A FINAL WORD ON THE KEY ELEMENTS OF SUCCESS
		REFERENCES
Chapter-16---Complications-of-Rheumatic-Hea_2021_Acute-Rheumatic-Fever-and-R
	16. Complications of Rheumatic Heart Disease and Acute Emergencies
		INTRODUCTION
		1: ACUTE HEART FAILURE
			Definition and Classification
			Epidemiology
			Etiology of Acute Heart Failure
				Acute rheumatic fever
				Rheumatic heart disease
			Evaluation and Management of the Patient With Acute Heart Failure
				Phase I: Early recognition, treatment, and triage of life-threatening conditions
				Phase II: Identification and treatment of acute etiologies or relevant triggers of AHF
					Acute valvular regurgitation
					Acute valvular regurgitation
					Acute presentation of chronic disease
					Acute presentation of chronic disease
					Prosthetic valve dysfunction (mechanical and bioprosthetic valves)
					Prosthetic valve dysfunction (mechanical and bioprosthetic valves)
						Prosthetic valve thrombosis management
						Prosthetic valve thrombosis management
						Prosthetic valve stenosis
						Prosthetic valve stenosis
						Other prosthetic valve complications
						Other prosthetic valve complications
					Pericardial tamponade
					Pericardial tamponade
					Tachyarrhythmia in chronic mitral stenosis
					Tachyarrhythmia in chronic mitral stenosis
					Advanced heart block
					Advanced heart block
				Phase III: Diagnostic work-up to confirm acute heart failure
				Phase IV: Defining the clinical profile and optimal management strategy
					Diuretics
					Diuretics
					Vasodilators
					Vasodilators
					Ongoing management
					Ongoing management
			Conclusion
		2: INFECTIVE ENDOCARDITIS
			Introduction
			Pathophysiology of Infective Endocarditis in Rheumatic Heart Disease
			Epidemiology of Infective Endocarditis and Rheumatic Heart Disease
				High income countries
				Infective Endocarditis in Rheumatic Heart Disease-endemic countries
			Presenting Clinical Features
				Examination findings
			Investigations
				Laboratory investigations
					Bacterial pathogen/causative organisms
					Bacterial pathogen/causative organisms
			Imaging
				Echocardiography and newer imaging modalities
			Diagnostic Criteria
			Differential Diagnosis
			Medical Management
				Principles of antibiotic therapy for infective endocarditis
			Clinical Course and Complications
				Stroke/intracranial hemorrhage/neurologic events
				Other vascular complications
				Uncontrolled sepsis and persistent bacteremia
					Cardiac surgical management
					Cardiac surgical management
			Prognosis
			Prevention and Antibiotic Prophylaxis
			Conclusions
		3: OVERANTICOAGULATION AND BLEEDING
			Introduction
			Management
		REFERENCES
Index_2021_Acute-Rheumatic-Fever-and-Rheumatic-Heart-Disease
	Index
		A
		B
		C
		D
		E
		F
		G
		H
		I
		J
		L
		M
		N
		O
		P
		Q
		R
		S
		T
		U
		V
		W