RHD still a big problem – Dr Anita Saxena

2^nd National Heart Valve Summit 2012

b.     Africahighest problem

c.      Indianumber 3

d.      80%IndiaandAfrica

e.      Jones criteria 1992 no update after that

f.        Sub cutaneous nodules means carditis

g.       Erythema  Marginatum means carditis

h.      Carditis most imp prognostic

i.         Means valvulitis

j.        Carditis: MR, AR, carry Coombs Murmar, myocarditis, gallop, unexplained cardiomegaly,

k.       Sub clinical carditis can be picked up with echo, is benign, but still inIndiacannot be taken as a major criteria

l.         Trop I not useful in diagnosis

m.    QT dispersion > 40 ms can predict acute carditis

n.      CHF is not due to carditis, ACE inhibitors of choice, Na nitrorpuside can help in acute cases

o.      Steroids are not better than aspirin

p.      Steroids produce rapid resolution but does not reduce the duration of sickness

q.      Steroids in pericarditis, severe carditis, heart failure otherwise aspirin alone

r.        Surgery in acute carditis: can be done as heart failure is not due to carditis but valve involvement

s.       Surgery when medical therapy has failed.