Medical management of rheumatic heart disease: A systematic review of the evidence
MetadataShow full item record
Rheumatic heart disease (RHD) is an important cause of heart disease globally. Its management can encompass medical and procedural (catheter and surgical) interventions. Literature pertaining to the medical management of RHD from PubMed 1990-2016 and via selected article reference lists was reviewed. Areas included symptom management, left ventricular dysfunction, rate control in mitral stenosis, atrial fibrillation, anticoagulation, infective endocarditis prophylaxis, and management in pregnancy. Diuretics, angiotensin blockade and beta-blockers for left ventricular dysfunction, and beta-blockers and If inhibitors for rate control in mitral stenosis reduced symptoms and improved left ventricular function, but did not alter disease progression. Rhythm control for atrial fibrillation was preferred, and where this was not possible, rate control with beta-blockers was recommended. Anticoagulation was indicated where there was a history of cardioembolism, atrial fibrillation, spontaneous left atrial contrast, and mechanical prosthetic valves. While warfarin remained the agent of choice for mechanical valve implantation, non-Vitamin K antagonist oral anticoagulants may have a role in RHD-related AF, particularly with valvular regurgitation. Evidence for anticoagulation after bioprosthetic valve implantation or mitral valve repair was limited. RHD patients are at increased risk of endocarditis, but the evidence supporting antibiotic prophylaxis before procedures that may induce bacteremia is limited and recommendations vary. The management of RHD in pregnancy presents particular challenges, especially regarding decompensation of previously stable disease, the choice of anticoagulation, and the safety of medications in both pregnancy and breast feeding.
Showing items related by title, author, creator and subject.
Russell, E.; Tran, L.; Baker, R.; Bennetts, J.; Brown, A.; Reid, Christopher; Tam, R.; Walsh, W.; Maguire, G. (2014)Background: Globally, rheumatic heart disease (RHD) remains an important cause of heart disease. In Australia it particularly affects older non-Indigenous Australians and Aboriginal Australians and/or Torres Strait Islander ...
Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International clarify registryFauchier, L.; Greenlaw, N.; Ferrari, R.; Ford, I.; Fox, K.; Tardif, J.; Tendera, M.; Steg, P.; Sokn, F.; Reid, Christopher; Lang, I.; Van Den Branden, F.; César, L.; Mattos, M.; Luqman, H.; Goudev, A.; Dorian, P.; Hu, D.; Widimsky, P.; Hassager, C.; Danchin, N.; Kääb, S.; Vardas, P.; Sulaiman, K.; Al Mahmeed, W.; Al Suwaidi, J.; Al Rashdan, I.; Abdulkader, F.; Merkely, B.; Kaul, U.; Daly, K.; Tavazzi, L.; Jang, Y.; Erglis, A.; Laucevicius, A.; Jamaluddin, A.; Gamba, M.; Tulevski, I.; Stepinska, J.; Morais, J.; Macarie, C.; Oganov, R.; Shalnova, S.; Al-Zaibag, M.; Hou, M.; Kamensky, G.; Fras, Z.; Kanic, V.; Naidoo, D.; Zamorano, J.; Rickli, H.; Jaussi, A.; Sriratanasathavorn, C.; Kalra, P.; Lutai, M.; Oleksandr; Nguyen, L.; Henry, R. (2015)© 2015 Fauchier et al. Background: Few data are available regarding the use of antithrombotic strategies in coronary artery disease patients with atrial fibrillation (AF) in everyday practice. We sought to describe the ...
The burden and implications of preoperative atrial fibrillation in Australian heart valve surgery patientsRussell, E.; Walsh, W.; Tran, L.; Tam, R.; Reid, Christopher; Brown, A.; Bennetts, J.; Baker, R.; Maguire, G. (2017)Background Atrial fibrillation (AF) is the most common preoperative arrhythmia in heart valve surgery patients and its prevalence is rising. This study aims to investigate the impact of AF on valve surgery early complications ...