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what next step in asymptomatic MVP ? reassurance or echo

what initial treatment of Rheumatoid arthritis ? Methotrexate or Aspirin
 

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initial treatment of Rheumatoid arthritis is DMARD (Methotrexate)
because NSAID does not decrease RA progress


asymptomatic MVP next step Mx is echo
 

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initial treatment of RA if there is pain and temperature >>> ASPIRIN

but otherwise Methotrexate



IN MVP I am not sure and confuse between reassurance or echo because she is asymptomatic :notsure:
 

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ACC/AHA guidelines
Class I - There is evidence and/or general agreement that echocardiography should be performed in patients with suspected MVP in the following setting• Among patients with physical findings of MVP, to establish the diagnosis and to assess leaflet morphology and for possible mitral regurgitation (MR) and ventricular compensation.

Class IIa - The weight of evidence or opinion is in favor of the usefulness of echocardiography in patients with possible or known MVP in the following settings• To exclude MVP when the diagnosis has been made in the absence of supporting clinical evidence.• For risk stratification in patients with known MVP or physical signs of MVP.

Class III - There is evidence and/or general agreement that echocardiography is not useful in patients with suspected or known MVP in in the following settings• To exclude MVP in the setting of ill-defined symptoms in the absence of a positive family history or suggestive clinical symptoms or physical findings.• Routine repeat echocardiography for known MVP in the absence of MR or in the presence of mild MR with no change in clinical signs or symptoms.

So if there is no symptom -->reassurance
 
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