The occurrence of valvular and myocardial disease in patients with chronic joint deformity

Weintraub, Alan M.; Zvaifler, Nathan J.

doi:10.1016/0002-9343(63)90206-7

Cited by 54 publications

(15 citation statements)

References 22 publications

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“…Specific valvular endocarditis is rare, being observed at necropsy in most cases, since the valvular lesions are rarely clinically so severe as to require surgery (6,II ,12,15). In fact, only 8 cases of aortic valve replacement for aortic regurgitation in patien ts with rheumatoid arthritis have Downloaded by: National University of Singapore.…”

Section: Discussionmentioning

confidence: 99%

“…

Card iac valv u lar invo lveme nt in pati en t s wi t h rh eum at oi d art hrit is is rare and seldom so sever e as to re qu ire surg e ry.T he present report is co nce rned w it h a case of rheu mato id aort ic incompete nce successfu lly t reated by prostheti c valve rep lacemen t. As suggested by p reviou s simi lar reports, surq ery is t he most effect ive t herapy for c linica lly sign ifica nt rh eumatoid endo ca rditis.Key-Words : Rheumato id aort ic incom petence -Th er apy by p rost hetic valve repl acement Cardiac disease and peripheral rheumatoid arthritis are, today, known to be associated, and although cardiac involvement is not always clinically evident it has been repeatedly documented pathol ogically (I ,3,6,9, II ,12,13,15). Moreover, the importance of prosthet ic valve replacement as an effective treatment of severe rheumat oid endocarditis has been recentl y outlined (4, 7,8 , 16).

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mentioning

confidence: 99%

“…Key-Words : Rheumato id aort ic incom petence -Th er apy by p rost hetic valve repl acement Cardiac disease and peripheral rheumatoid arthritis are, today, known to be associated, and although cardiac involvement is not always clinically evident it has been repeatedly documented pathol ogically (I ,3,6,9, II ,12,13,15). Moreover, the importance of prosthet ic valve replacement as an effective treatment of severe rheumat oid endocarditis has been recentl y outlined (4, 7,8 , 16).…”

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Aortic Valve Replacement in Rheumatoid Aortic Incompetence

Bortolotti¹,

Gallucci²,

Russo³

et al. 1981

Thorac cardiovasc Surg

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Section: Discussionmentioning

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Aortic Valve Replacement in Rheumatoid Aortic Incompetence

Bortolotti¹,

Gallucci²,

Russo³

et al. 1981

Thorac cardiovasc Surg

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“…Often the heart disease is overshadowed by the severe generalized rheumatoid process (Weintraub and Zvaifler, 1963) which so restricts the patient's activity that exertional symptoms do not arise (Hart, 1969;Barker, 1971). These factors, together with the frequent mildness of cardiac lesions which are only occasionally haemodynamically significant (Weintraub and Zvaifler, 1963) have suggested to some authors that the cardiac lesions of rheumatoid arthritis are an academic curiosity rather than a clinical problem (Downie and Buchanan, 1969).…”

Section: Discussionmentioning

confidence: 99%

“…These factors, together with the frequent mildness of cardiac lesions which are only occasionally haemodynamically significant (Weintraub and Zvaifler, 1963) have suggested to some authors that the cardiac lesions of rheumatoid arthritis are an academic curiosity rather than a clinical problem (Downie and Buchanan, 1969). Bonfiglio and Atwater (1969) felt that the cardiac lesions may not be as benign as their reputation suggests, having found cardiac granulomata in 2 of 47 autopsied patients whom they reviewed, and this agrees with the 1-3 % figure quoted by Sokoloff (1953).…”

Section: Discussionmentioning

confidence: 99%

Aortic valve incompetence and replacement in rheumatoid arthritis.

Iveson¹,

Thadani²,

Ionescu³

et al. 1975

Annals of the Rheumatic Diseases

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Infirmary at LeedsIveson, J. M. I., Thadani, U., Ionescu, M., and Wright, V. (1975.) Annals of the Rheumatic Diseases, 34, 312-320. Aortic valve incompetence and replacement in rheumatoid arthritis. 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 pericardectomy previously for constrictive pericarditis. Good results were obtained in all four operated cases and cardiac surgery enabled continuation of rehabilitation for the rheumatoid arthritis, including major orthopaedic procedures.A review of 22 cases from the literature with rheumatoid granulomata within the aortic valve shows that they are associated with mitral valve granulomata in 63-6%. Congestive cardiac failure was found in 75 %. Macroscopical evidence of aortic incompetence was seen in 36-8 % and of aortic stenosis in 15 8%. Associated pericarditis occurred in 59-1 %, which was severe or complicated in 13.6%. The associated arthritis was severe in 77-8% with subcutaneous nodules (71-5%), rheumatoid factor (83 6%), and episcleritis (66 6 %). From these cases and a review of the literature the following points are emphasized. (1) Both the granulomatous and nonspecific aortic valvulitis of rheumatoid arthritis may result in significant haemodynamic abnormality. (2) The valve lesions found are often clinically and macroscopically indistinguishable from rheumatic valve lesions. (3) Granulomata, when present, are usually found in the valve cusp or ring and only occasionally in the aortic wall. (4) Associated joint disease, although usually severe, may be mild. (5) The valve lesion may be accompanied by a severe pericardial involvement-either tamponade or constriction. (6) Aortic valve replacement for aortic incompetence in rheumatoid arthritis is both feasible and worthwhile, despite severe joint disease.

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Chronic postrheumatic-fever (Jaccoud's) arthritis. Case report with the rheumatoid factor and a family history of rheumatoid arthritis

Burda¹,

Sanders²

1967

Archives of Internal Medicine

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The occurrence of valvular and myocardial disease in patients with chronic joint deformity

Cited by 54 publications

References 22 publications

Aortic Valve Replacement in Rheumatoid Aortic Incompetence

Aortic Valve Replacement in Rheumatoid Aortic Incompetence

Aortic valve incompetence and replacement in rheumatoid arthritis.

Chronic postrheumatic-fever (Jaccoud's) arthritis. Case report with the rheumatoid factor and a family history of rheumatoid arthritis

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