Podcast appearances and mentions of jones criteria

Welcome to PICU Doc on Call, a podcast dedicated to current and aspiring intensivists. I'm Pradeep Kumar coming to you from Children's Healthcare of Atlanta, Emory University School of Medicine, and I'm Rahul Damania from Cleveland Clinic Children's Hospital. We are two pediatric ICU physicians passionate about all things medical education in the PICU.Episode Overview: PICU.com call focuses on interesting PICU cases and management in the acute care Pediatric setting. In this episode, we discuss the case of an eight-year-old boy with chest pain, fatigue, and shortness of breath. This case presentation by Rahul highlights the complexity of pediatric care in the PICU.Case Presentation: An eight-year-old boy with up-to-date immunizations and no recent travel or pet exposure presented to the PICU with chief complaints of chest pain, fatigue, and decreased oral intake. His history over the preceding two weeks included a diminishing appetite, episodes of vomiting, and shortness of breath.On examination, he exhibited various cardiac findings, including a hyperdynamic left ventricle, murmurs, and a noted gallop. Abdominal and neurological findings were also concerning. Diagnostic studies revealed an enlarged heart, and sinus tachycardia with left ventricular hypertrophy, and echocardiography confirmed severe valvular and ventricular abnormalities.Laboratory Findings:Laboratory findings included elevated BNP, slightly elevated troponin, and elevated inflammatory markers (ESR and CRP). Strep throat culture was negative, but ASO and anti-DNAse B titers were markedly elevated. MRI confirmed multiple punctate infarctions, likely due to valvular heart disease.Diagnosis: Given the complex multisystem presentation, the child was admitted to the PICU for intensive monitoring and comprehensive management of this multisystem pathology. The working diagnosis is rheumatic fever.The episode is organized into three parts:Pathophysiology of Acute Rheumatic FeverApproach to Diagnosis and InvestigationsManagement and PreventionPathophysiology of Acute Rheumatic Fever: Acute rheumatic fever is an autoimmune disease initiated by a response to group A strep infection, primarily due to molecular mimicry. The streptococcal M protein has structural similarities with host proteins, leading to organ damage, especially in the heart.Epidemiology: Acute rheumatic fever is most prevalent in low to middle-income areas, affecting over 80% of cases. It mainly affects children between 5 to 14 years of age, and overcrowded households and limited healthcare access increase the risk. Globally, rheumatic heart disease affects millions of people annually and claims many lives.Jones Criteria for Diagnosis: The Jones criteria help diagnose acute rheumatic fever. For

Rapha e João discutem um caso apresentado pelo Iago envolvendo febre e sopro. Quais as características de um sopro benigno? Quais as principais causas de valvopatias? Qual a importância de usar termos médicos na passagem de caso e como isso afeta o raciocínio clínico? Essas e outras clinicagens você encontra nesse episódio! Ficou com alguma dúvida, que mandar uma crítica ou sugestão? Entra em contato com a gente através do Instagram ou Twitter @tadeclinicagem Minutagem (4:09) Apresentação do caso (6:02) Início do raciocínio clínico (11:38) Complementação do caso (13:47) Cometários sobre caso (15:26) Sopros (21:50) Doenças valvares (29:35) Doença valvar e febre (31:42) Endocardite (33:27) Febre reumática aguda (39:57) Continuação do caso (41:30) Racicionio após exames complementares (43:20) Resolução do caso (44:45) Salves ( 46:26) Resposta do desafio anterior (48:35) Desafio da semana Referências 1) UPTODATE 2020. Auscultation of cardiac murmurs in adults. Theo E Meyer 2) ETCHELLS, Edward; BELL, Chaim; ROBB, Kenneth. Does this patient have an abnormal systolic murmur?. Jama, v. 277, n. 7, p. 564-571, 1997 3) TARASOUTCHI, Flavio et al. Atualização das Diretrizes Brasileiras de Valvopatias–2020. Arquivos Brasileiros de Cardiologia, v. 115, n. 4, p. 720-775, 2020 4) HØYTE, Henning; JENSEN, Torstein; GJESDAL, Knut. Cardiac auscultation training of medical students: a comparison of electronic sensor-based and acoustic stethoscopes. BMC Medical Education, v. 5, n. 1, p. 14, 2005 5) NISHIMURA, Rick A. et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, v. 63, n. 22, p. e57-e185, 2014 6) MCGEE, Steven. Etiology and diagnosis of systolic murmurs in adults. The American journal of medicine, v. 123, n. 10, p. 913-921. e1, 2010 7) JOST, Christine H. Attenhofer et al. Echocardiography in the evaluation of systolic murmurs of unknown cause. The American journal of medicine, v. 108, n. 8, p. 614-620, 2000 8) GEWITZ, Michael H. et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation, v. 131, n. 20, p. 1806-1818, 2015. 9) HABIB, Gilbert et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of infective endocarditis of the European Society of Cardiology (ESC) endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). European heart journal, v. 36, n. 44, p. 3075-3128, 2015.

This episode of CRACKCast reviews Rosen’s Chapter 170, Pediatric Cardiac Disorders. This podcast covers the common infectious complications leading to pediatric cardiac issues. Additionally, we will review Kawasaki's Disease, Acute Rheumatic Fever, HOCM, and much more.  Episode Overview: 1. Describe procedures and conditions for which prophylaxis for bacterial endocarditis is recommended. 2. Describe 2 potential prophylaxis regimens. 3. What is the differential diagnosis of myocarditis? What is the most common cause of myocarditis in children? 4. What is the differential diagnosis of pericarditis in children? Describe any differences b/n adults and children. 5. What are the clinical diagnostic criteria for Kawasaki’s disease? 6. If the clinical criteria are not met, but you are still suspicious, how else might Kawasaki’s disease be diagnosed? 7. What are some unusual clinical presentations of Kawasaki’s disease? 8. How is Kawasaki’s disease managed? What is treatment directed towards preventing? 9. List the Jones Criteria for the diagnosis of Acute Rheumatic Fever. 10. Describe the management of Acute Rheumatic Fever. 11. List 10 causes of sudden death in young athletes. 12. What is a normal pediatric QT interval. 13. What are ECG findings of HCM? Wisecracks: 1. What is the hyperoxia test? How is it clinically useful? 2. Describe common Xray findings in CHD: “boot-shaped heart”, “egg-on-a-string”, “snowman”. 3. What is Eisenmenger’s Syndrome? 4. Until what age is the thymus visible on CXR? 5. List 8 ductal dependent cardiac lesions in the neonate. 6. List features of pathologic heart murmur . 7. When does the ductus arteriosus close functionally? Physically?

This episode of CRACKCast reviews Rosen’s Chapter 170, Pediatric Cardiac Disorders. This podcast covers the common infectious complications leading to pediatric cardiac issues. Additionally, we will review Kawasaki's Disease, Acute Rheumatic Fever, HOCM, and much more.  Episode Overview: 1. Describe procedures and conditions for which prophylaxis for bacterial endocarditis is recommended. 2. Describe 2 potential prophylaxis regimens. 3. What is the differential diagnosis of myocarditis? What is the most common cause of myocarditis in children? 4. What is the differential diagnosis of pericarditis in children? Describe any differences b/n adults and children. 5. What are the clinical diagnostic criteria for Kawasaki’s disease? 6. If the clinical criteria are not met, but you are still suspicious, how else might Kawasaki’s disease be diagnosed? 7. What are some unusual clinical presentations of Kawasaki’s disease? 8. How is Kawasaki’s disease managed? What is treatment directed towards preventing? 9. List the Jones Criteria for the diagnosis of Acute Rheumatic Fever. 10. Describe the management of Acute Rheumatic Fever. 11. List 10 causes of sudden death in young athletes. 12. What is a normal pediatric QT interval. 13. What are ECG findings of HCM? Wisecracks: 1. What is the hyperoxia test? How is it clinically useful? 2. Describe common Xray findings in CHD: “boot-shaped heart”, “egg-on-a-string”, “snowman”. 3. What is Eisenmenger’s Syndrome? 4. Until what age is the thymus visible on CXR? 5. List 8 ductal dependent cardiac lesions in the neonate. 6. List features of pathologic heart murmur . 7. When does the ductus arteriosus close functionally? Physically?

This episode covers Chapter 83 of Rosen's Emergency Medicine.   List 6 RFs for bacterial endocarditis List 5 common bacteria responsible for infective endocarditis Give three examples of immunologic sequelae of IE. Give three examples of vascular sequelae of IE. What are the diagnostic criteria for endocarditis, and how are they used? List 5 lab or investigative findings in bacterial endocarditis Describe the treatment of infective endocarditis List four complications of IE. List the indications for infectious endocarditis prophylaxis. What are the empiric antibiotics used for pts with suspected infectious endocarditis? Describe the Jones Criteria for Acute Rheumatic Fever What is the treatment of rheumatic fever Name three causes of acute mitral regurgitation. How is acute MR managed? What is the pathophysiology of mitral valve prolapse?  How does it present? List four causes of mitral stenosis. List four causes of aortic valve insufficiency. List 3 physical exam findings associated with AS What is critical aortic stenosis?Outline the ED management for a pt with critical aortic stenosis with CHF and hypotension. List 5 complications of prosthetic valves.  WiseCracks: Describe Janeway lesions Osler nodes Splinter hemorrhages Roth Spots What are the HACEK organisms, and what is their significance in pts with IE? Brief run down of all valvular disease - in one or two lines.

This episode covers Chapter 83 of Rosen's Emergency Medicine.   List 6 RFs for bacterial endocarditis List 5 common bacteria responsible for infective endocarditis Give three examples of immunologic sequelae of IE. Give three examples of vascular sequelae of IE. What are the diagnostic criteria for endocarditis, and how are they used? List 5 lab or investigative findings in bacterial endocarditis Describe the treatment of infective endocarditis List four complications of IE. List the indications for infectious endocarditis prophylaxis. What are the empiric antibiotics used for pts with suspected infectious endocarditis? Describe the Jones Criteria for Acute Rheumatic Fever What is the treatment of rheumatic fever Name three causes of acute mitral regurgitation. How is acute MR managed? What is the pathophysiology of mitral valve prolapse?  How does it present? List four causes of mitral stenosis. List four causes of aortic valve insufficiency. List 3 physical exam findings associated with AS What is critical aortic stenosis?Outline the ED management for a pt with critical aortic stenosis with CHF and hypotension. List 5 complications of prosthetic valves.  WiseCracks: Describe Janeway lesions Osler nodes Splinter hemorrhages Roth Spots What are the HACEK organisms, and what is their significance in pts with IE? Brief run down of all valvular disease - in one or two lines.

In this podcast, Professor Ganesan Karthikeyan, the Editor-in-Chief of Heart Asia, interviews Dr Andrea Beaton about the 2015's revision of the Jones criteria for the diagnosis of acute rheumatic fever (ARF) and its major implications for practice in low-income and middle-income countries. Dr Andrea Beaton is the co-author with Jonathan Carapetis of this paper, accessible here: http://heartasia.bmj.com/content/7/2/7.full.