Role of ECHO emphasized in management of rheumatic heart disease

In a report from the American Society of Echocardiography, published in the Jan. 1 issue of the Journal of the American Society of Echocardiography, the authors emphasize the role of echocardiography in the management of rheumatic heart disease (RHD).

Natesa G. Pandian, M.D., from Hoag Hospital in Newport Beach, California, and colleagues present recommendations for the use of echocardiography in the diagnosis and therapeutic intervention of RHD.

The authors note that when typical findings of valvular and subvalvular abnormalities are seen, including commissural fusion, leaflet thickening, and restricted leaflet mobility, with varying degrees of calcification, echocardiographic diagnosis of RHD is made. The mitral valve is mainly affected, frequently resulting in mitral stenosis. Mixed valve disease and associated cardiopulmonary pathology occur frequently.

Rigorous examination of the severity of valvular lesions and hemodynamic effects on the cardiac chambers and pulmonary artery pressures should be undertaken. For diagnostic and strategic pretreatment planning, all available modalities of echocardiography should be used to obtain accurate anatomic and hemodynamic details of the affected valve lesion(s).

During catheter-based or surgical treatment of RHD, intraprocedural echocardiographic guidance is critical, as is echocardiographic surveillance for postintervention complications or disease progression.

"Echocardiography, with its multifaceted imaging approach, plays a critical role in the diagnosis, assessment of severity, detection of complications, and in guiding therapy," Pandian said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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