RESUMO
The analysis of life-time diagnosis of valvular heart disease in rheumatoid arthritis (RA) patients has been made basing on a long-term clinico-echocardiographic investigation. Within 18-year follow-up valvular disease was revealed in 17 out of 214 RA patients (7.9%). Only 3 patients developed the disease in childhood prior to RA diagnosis. In 8 patients the diagnosis of valvular disease was established in the presence of RA, in 6 RA patients the disease was determined during the follow-up period. Mitral stenosis, aortal stenosis, combined mitral valve incompetence, combined aortal defect, mitral defect and tricuspid incompetence, combined mitral defect and pulmonary artery valvular incompetence were detected in 2, 2, 3, 1, 1, and 1 patients, respectively. Valvular disease occurs more frequently in progredient seropositive RA uncontrollable by on-going therapy. The authors emphasize the value of a prospective clinical echocardiographic examination of RA patients in early diagnosis of valvular disease in them. Frequent valvular lesions in RA patients dictate the need of persistent antirheumatic therapy to inhibit the activity and prevent progression of the disease.
Assuntos
Valva Aórtica/diagnóstico por imagem , Artrite Reumatoide/diagnóstico por imagem , Ecocardiografia , Valva Mitral/diagnóstico por imagem , Cardiopatia Reumática/diagnóstico por imagem , Adulto , Idoso , Artrite Reumatoide/epidemiologia , Progressão da Doença , Ecocardiografia/estatística & dados numéricos , Feminino , Seguimentos , Doenças das Valvas Cardíacas/diagnóstico por imagem , Doenças das Valvas Cardíacas/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Cardiopatia Reumática/epidemiologia , Fatores de TempoAssuntos
Neoplasias Cardíacas/diagnóstico , Mixoma/diagnóstico , Adulto , Doença das Coronárias/diagnóstico , Diagnóstico Diferencial , Erros de Diagnóstico , Ecocardiografia , Feminino , Átrios do Coração/diagnóstico por imagem , Neoplasias Cardíacas/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Mixoma/diagnóstico por imagem , Insuficiência Respiratória/diagnósticoRESUMO
Clinical appearance and misdiagnosis in 27 patients having associated preexcitation syndrome and mitral prolapse have been analyzed. Misdiagnosis of myocardial infarction, rheumatic and congenital heart disease, infectious-allergic myocarditis were most typical errors in this condition identification: in 9, 3 and 2 patients, respectively.