We studied 20 patients, mostly young adult men, with cardiac involvement of Lyme disease. The commonest abnormality (18 patients) was fluctuating degrees of atrioventricular block; eight of them developed complete heart block. Thirteen patients had evidence of more diffuse cardiac involvement: electrocardiographic changes compatible with acute myopericarditis (11 patients), radionuclide evidence of mild left ventricular dysfunction (five of 12 patients tested), or frank cardiomegaly (one patient). Heart involvement was usually preceded by erythema chronicum migrans and sometimes accompanied by meningoencephalitis, facial palsy, arthritis, elevated serum IgM levels, or cryoglobulins containing IgM. The duration of cardiac involvement was usually brief (3 days to 6 weeks). The clinical picture in these patients has similarities to acute rheumatic fever; but in Lyme disease, complete heart block may be commoner, myopericardial involvement tends to be milder, and valves seem not to be affected.

Lyme Carditis: Cardiac Abnormalities of Lyme Disease

Spatial variation of QT intervals in normal persons and patients with acute myocardial infarction

Why is heart failure in children important? If we just consider the number of individuals affected, adult heart failure is clearly a more compelling public health problem. However, the relatively small numbers belie the overall economic and social impact of pediatric heart failure. When a child is admitted to the hospital for heart failure, the costs are considerably higher for children than adults because of the frequent need for surgical or catheter-based intervention. The demands of medical care can fray the family structure and adversely affect parental economic productivity. When a child dies of heart failure, the economic impact is magnified enormously because of the number of potentially productive years lost per death. For these and other reasons, heart failure in children is a serious public health concern.

In addition, growing numbers of children with heart failure are reaching adulthood because of the successful application of medical and surgical heart failure therapies and the improved outcomes of congenital heart surgery. A greater understanding of the pathophysiology of heart failure in childhood may help inform therapeutic strategies once these children become adults. Furthermore, given the recent explosion of research in the impact of cardiac development and cardiogenetics on pediatric cardiovascular disease, it is not outside the realm of possibility for a pediatric discovery to be made that will also benefit adults with heart failure.

We may not yet be able to agree on a definition of heart failure, but the cardinal symptoms, dyspnea, anasarca (“dropsy”), and cachexia, were well recognized in antiquity.1 These symptoms were not specific for cardiac pathology, and it was not until the 17th century, when William Harvey definitively identified the heart as an organ that pumped blood rather than generating heat, that the heart could begin to be understood as a source of dyspnea, edema, and …

Heart Failure in Children Part I: History, Etiology, and Pathophysiology

Background— Unlike the Western world, valvular disease ranks among the major cardiovascular afflictions in Africa. Acute rheumatic fever and chronic rheumatic valvular disease in their most virulent form are still commonly encountered and impose a huge burden on limited healthcare resources. Methods and Results— We performed a systematic review of the literature with PubMed using rheumatic fever, rheumatic heart disease, valvular disease, warfarin anticoagulation, and pregnancy as search items. Literature emanating from Africa was emphasized. Epidemiology, current concepts on pathogenesis, and aspects of the medical and surgical management of this disease as seen from an African perspective are presented. The association of pregnancy with mitral stenosis is common and may be fatal if not managed appropriately. A practical approach to these patients is presented to optimize maternal and fetal outcome. Pregnant patients with mechanical valves require careful attention to ensure maternal survival and prevent...

Rheumatic and Nonrheumatic Valvular Heart Disease Epidemiology, Management, and Prevention in Africa

Objectives: To investigate the progress of rheumatic fever (RF) and the predictors of severe chronic valvar disease.

Design: Patients prospectively followed up since their first attack of acute RF (ARF).

Setting: Universidade Federal de Minas Gerais, Brazil.

Patients: 258 children and adolescents who met the revised Jones criteria for RF. The follow up period ranged from 2–15 years.

Main outcome measures: The presence and severity of mitral or aortic valvar disease were determined by both clinical and Doppler echocardiographic examinations. The variables associated with severe chronic valvar disease were initially identified by the Kaplan-Meier method and, later, by multivariate analysis.

Results: Doppler echocardiography of 258 patients studied showed that 186 (72.1%) developed chronic valvar disease and 41 (15.9%) progressed to severe chronic mitral or aortic lesions. Of 146 patients who developed carditis, 49 (33.6%) had a normal clinical examination in the chronic phase but only nine (6.2%) had normal Doppler echocardiographic findings—that is, 40 (27.4%) patients progressed to chronic subclinical valvar disease. Moderate or severe carditis, recurrences of ARF, and mother’s low educational level were risk factors in predicting severe chronic valvar diseases.

Conclusion: The increased risk of progressing to severe chronic valvar disease was associated with moderate or severe carditis, recurrences of ARF, and mother’s low educational level. Hence, in a country such as Brazil, the options available for disease control are mainly primary and secondary prophylaxis.

https://heart.bmj.com/content/heartjnl/91/8/1019.full.pdf

Long term follow up of rheumatic fever and predictors of severe rheumatic valvar disease in Brazilian children and adolescents

Disappearance of significant murmurs was twice as common in 47 rheumatic children treated with large doses of hormones as in a comparable group of 41 children treated with small doses of hormones. Results were also related to the duration of illness before therapy was started. The findings suggest that the divergencies of opinion regarding the efficacy of hormones in the treatment of acute rheumatic carditis may in part be explained on the basis of differences in doses of hormones, in duration of therapy, and in duration of illness before the beginning of therapy.

Comparison of Large and Small Doses of Hormones in the Treatment of Acute Rheumatic Carditis

A RECENT review of the literature1 and our own experience at the House of the Good Samaritan2 3 4 5 suggest that early treatment of rheumatic fever with ACTH and cortisone may prevent or mitigate heart damage. Early treatment is dependent on early diagnosis of the disease. Clinically, rheumatic fever is diagnosed by such manifestations as subcutaneous nodules, chorea, erythema marginatum, carditis and arthritis. Subcutaneous nodules are a late manifestation, and chorea and erythema marginatum occur sometimes early but also frequently late in the course of the disease. When definite carditis (significant murmurs or congestive heart failure) has been established, some irreversible damage . . .

Application of the antistreptolysin-O titer in the evaluation of joint pain and in the diagnosis of rheumatic fever.

T HE GENERAL purpose of the studies to be (1) What is the frequency of the principal reported here is to present the clinical manifestations of rheumatic fever? How do picture of rheumatic fever in initial attacks as it these manifestations contribute to diagnosis, and has been observed during recent years at the what is their significance in regard to the more House of the Good Samaritan. In particular, immediate prognosis? an attempt will be made to answer the following (2) What is the clinical course of rheumatic three sets of questions : fever in its initial attack? When carditis de-

The clinical picture of rheumatic fever: diagnosis, immediate prognosis, course, and therapeutic implications.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Sujoy B. Roy

Author Tools

Chat about Author

Papers

Comparison of Large and Small Doses of Hormones in the Treatment of Acute Rheumatic Carditis

Application of the antistreptolysin-O titer in the evaluation of joint pain and in the diagnosis of rheumatic fever.

The clinical picture of rheumatic fever: diagnosis, immediate prognosis, course, and therapeutic implications.