Rheumatoid arthritis, these three symptoms must be understood

1. Mitral regurgitation

Patients with rheumatic mitral regurgitation often have only mild symptoms. Symptoms worsen when there is rheumatic activity, infective endocarditis or rupture of chordae tendineae. 75% of patients with mitral regurgitation experience atrial fibrillation, which can increase the pressure in the left atrium. Excessive left ventricular capacity is another important cause of mitral regurgitation and palpitations and shortness of breath in patients. In the later stages of the disease, there may be pulmonary edema, hemoptysis and right heart failure.

2. Aortic stenosis

Patients with aortic stenosis may be asymptomatic during the compensation period, while patients with severe stenosis of the valve orifice often experience fatigue, dyspnea (exertional or paroxysmal), angina, dizziness or syncope, and even sudden death.

(1) Angina

Angina occurs in 20% to 60% of patients, and the pain increases with age and the severity of the valve orifice. The occurrence of angina indicates that the aortic valve orifice stenosis is quite serious. Angina can occur after fatigue or at rest, indicating that it is not necessarily related to fatigue and physical activity.

(2) Dizziness or syncope

About 30% of patients experience dizziness or syncope, which can last from as short as 1 minute to as long as more than half an hour. Some patients also have Adams-Stokes syndrome or arrhythmia. Dizziness or syncope often occurs after exertion or when the body is bent forward, sometimes at rest, when suddenly changing position, or when taking nitroglycerin sublingually to treat angina.

3. Tricuspid stenosis

The clinical manifestations of tricuspid stenosis may not be obvious or may be confused with the symptoms of mitral stenosis due to the coexistence of mitral stenosis. Patients are prone to fatigue and often complain of discomfort or bloating in the right upper abdomen and general edema. The obvious pulsation of the jugular vein often causes patients to have a throbbing discomfort in the neck. In addition, due to gastrointestinal congestion, patients often complain of loss of appetite, nausea, vomiting or belching. A small number of patients may also experience syncope, periodic cyanosis or discomfort behind the sternum, and may have difficulty breathing.