Rheumatic heart disease

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Rheumatic heart disease:

Rheumatic heart disease Prepared by : Matyiestenia Gravis

Aetiology & Pathogenesis:

Aetiology & Pathogenesis Cross-react between cardiac glycoprotein ( protein M ) with anti-streptococcus antibody Leads to inflammation  pancarditis B-hemolytic group A strepcocci ( strep pyogenes ) 3 weeks after strep throat infection DIAGNOSED CLINICALLY BY REVISED JONES CRITERIA

REVISED JONES CRITERIA:

REVISED JONES CRITERIA MAJOR & MINOR ( 5:3) DIAGNOSIS : 2 major / 2 minor + 1 major after strep infection ( WHO ) … Recurrent RF – 2 minor after strep infection Major : Carditis , Polyarthritis , E rythema marginatum , Sydenham Chorea , Nodules Minor : Fever, althralgia , previous rheumatic fever, elevated CRP & ESR, prolonged PR interval

Investigation:

Investigation NOT DIAGNOSTIC..Revised Jones Criteria JUST TO confirm recent strep infection ASOT – elevated means recent strep infection Throat culture + rapid antigen test CRP & ESR – ELEVATED ..both are minor criterias Blood culture to rule out widespread gonococcal infection , IE, and bacteremia CXR – CCF 2’ to carditis , Echo : involvement of valves Ecg – prolonged PR interval

Management:

Management Penicillin to kills strep pyogenes Aspirin for althralgia and fever Prophylactic Penicillin to prevent recurrent RF and IE d.t damaged valves Treatments for heart failure Bed Rest for carditis Sydenham – valproic acid Surgical – long term complications ( valve )

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