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An in-depth analysis of valvular abnormalities in various connective tissue diseases, including systemic lupus erythematosus, antiphospholipid antibody syndrome, ankylosing spondylitis, rheumatoid arthritis, scleroderma, polymyositis, and mixed connective tissue disease. It covers the prevalence, echo findings, differential diagnosis, and therapy for each disease.
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Autopsy prevelence
Cardiac tamponade
Prevalence of Pericarditis in Pts with SLE
2 mm for AV
Abnormal Leaflet Thickening in SLE
Differential Diagnosis
Libman-Sacks vegetation
Vibratory or rotatory motion independent of
A clinical syndrome of active SLE mimics IE. Low WBC count
Leaflet thickening localized to the leaflet tips
Chordal thickening, fusion, tethered motion
Valve sclerosis is marked in the valve annulus. Frequently associated with calcification
Differential Diagnosis
Abnormal Leaflet Thickening in SLE
Clinical Course of Pts with SLE
and Valvular DIsease
Vegetation, valvulitis, and LA thrombus in 70 to 90%
Refractory HF, infective endocarditis, complicated postoperative course and CVA
Therapy of Pts with SLE and
Valvular Disease
Aortic Root Disease and Valve Disease Associated with Ankylosing Spondylitis
The inflammatory process predominantly of the adventitia and intima of the aortic root results in a fibroblastic reparative response and vascularized fibrous tissue thickening
dilation
Autopsy studies; 24 to 100% Echo studies
Nonspecific thickening of aortic and mitral valves Increased echogenicity of the posterior aortic
Mild-to-moderate aortic regurgitation
Aortic Root Disease and Valve Disease Associated with Ankylosing Spondylitis
39-mon F/U of 25 patients
severe aortitis and valvular dysfunction
pts with moderate valvular regurgitation
Aortic Root Disease and Valve Disease Associated with Ankylosing Spondylitis
Cardiac Disease Associated with Rheumatoid Arthritis
Autopsy studies; 40% Echo studies; 50% Clinically significant pericardial effusion;