Rheumatic%20fever%20-%20acute Management

Management

Follow Up

Monitoring

Inflammatory markers (eg CRP, ESR) may be used to monitor acute disease process and response to therapy
Initial measurement is done twice a week then every 1-2 weeks until levels return to normal off therapy
ESR may stay elevated for up to 2 months while CRP usually goes back to normal level after a few days once acute inflammation has resolved
Increase in inflammatory marker level while treatment is being tapered suggests rebound of inflammation

Risk Factors for Recurrence

Lack of compliance to secondary prophylaxis
Multiple previous attacks
Shorter time interval since previous attack
Ongoing/increased exposure to streptococcal infections
Younger age
Presence of cardiac involvement

Dapagliflozin DELIVERs across full HF spectrum regardless of LVEF

Elvira Manzano, 04 Oct 2022

The selective, oral sodium–glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin reduces the risk of cardiovascular (CV) death or worsening heart failure (HF) in patients with HF and mildly reduced or preserved ejection fraction (HFmrEF or HFpEF) in the phase III DELIVER* trial, touted as the largest and most inclusive thus far in this patient group.

Ticagrelor benefits in TWILIGHT hold up in diabetes

Roshini Claire Anthony, 23 Apr 2020

Dropping aspirin after 3 months of dual therapy with ticagrelor reduced bleeding in patients with diabetes who have undergone PCI* vs taking both agents for 1 year, the TWILIGHT-DM** study has shown, consistent with benefits seen in TWILIGHT for other high-risk patients.

HK in CKD: Do diet, HD frequency matter?

Elvira Manzano, 28 Jun 2020

Hyperkalaemia (HK) occurrence and recurrence are frequent in advanced CKD*, creating a perfect storm for cardiovascular events and death, says Professor Juan-Jesus Carrero from the Karolinska Institute, Solna, Sweden, at ERA-EDTA 2020. Given these risks, acutely elevated potassium (K+) should merit clinical attention.