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Ongoing Dilemmas in RHD

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Dr Vikas Singh, Patna    06 January 2018

  1. Involvement of the heart mostly in the form of endocarditis and pericarditis is recognized. Myocardial involvement is missed many times, and requires a careful view in suspected cases.
  2. Modified Jones Criteria have been the backbone of diagnosis of acute rheumatic fever for decades. But, the availability and advantagesof echocardiography cannot be undermined, and it is now a very important tool in the diagnosis and management decisions.
  3. Leaky valves in adolescents is a cause of concern both for the patient and the treating physicians.
  4. Reassurance and discussing the natural history with the patient is an important part.
  5. It is equally important to have a clear idea about the medical management and when to intervene. Most of these conditions can be managed in a fairly nice way at present.

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