Rheumatic

Heart
Disease
Eunice Hil Arian V. Coscos
Qhyla Luaña
 Rheumatic
What is Heart Disease?
A condition in which the
heart valves have been
permanently damaged by
rheumatic fever.
PREDISPOSING Poor socio-economic status
Age 5-15 Years old
Previous History
Genetic Predisposition

Over Crowding PRECIPITATING

Climate or Season
Unexpected
Pregnancy
 Pathophysiology
of
Rheumatic Heart Disease
 RISK FACTORS GAS (GROUP A STREPOCCOCI) INFECTION UNTREATED SORETHROAT

RECURRENT INFECTION
DURING UNEXPECTED MOLECULAR MIMICRY

PREGNANCY

TISSUE DAMAGE

SKIN HEART GANGLIA JOINTS

SKIN LESIONS PANCARDITIS DESTRUCTION OF JOINT TISSUE POLYARTHRALGIA

FIBROUS THICKENING OF VALVES SYNDENHAMS CHOREA

ERYTHEMA MARGINATUM

FETAL GROWTH RESTRICTION

MITRAL VALVE STENOSIS AORTIC VALVE STENOSIS

PREMATURE BIRTH

IMPAIRED SYSTOLIC INADEQUATE BLOOD FLOW TO

LOW BIRTH WEIGHT
EJECTION PLACENTA

FETAL DISTRESS

CONGENITAL HEART DISEASAE

PULMONARY EDEMA ARRYHTMIA DYSPNIA SYNCOPE CHF

1 - SUPERIOR VENA 8 - PULMONARY
CAVA & 2- INFERIOR VEINS
9 - LEFT ATRIUM
VENA CAVA
10 - MITRAL
3 - RIGHT ATRIUM VALVE
4 - TRICUSPID VALVE 11 - LEFT
5 - RIGHT VENTRICLE VENTRICLE
12 - AORTIC
6 - PULMONARY VALVE
VALVE
7 - PULMONARY 13 - AORTA
ARTERIES
CLINICAL C RP INCREASED PROLONGED PR
MANIFESTATIONS INTERVAL

A THRALGIA A NAMNESIS OF
RHEUMATISM

J JOINT INVOLVEMENT
F EVER L EUKOCYTOSIS
O LOOKS LIKE A HEART =
MYOCARDITIS
E LEVATED ESR
N NODULES, SUBCUNTANEOUS

E ERYTHEMA MARGINATUM

S SYDENHAM CHOREA
DIAGNOSTIC TESTS
PHYSICAL EXAMINATION
WHILE A HEART MURMUR MAY
SUGGEST RHD, MANY PATIENTS
WITH RHD DO NOT HAVE A
MURMUR
MEDICAL HISTORY
INCLUDING EVIDENCE OF PAST ARF
OR STREP INFECTION
RAPID ANTIGEN TEST
DETERMINE THE PRESENCE OF
ANTIGEN PRESENT ON THE
STREPTOCOCCAL BACTERIA
ELECTROCARDIOGRAM (ECG)
TO CHECK IF THE CHAMBERS OF
THE HEART HAVE ENLARGED OR IF
THERE IS AN ABNORMAL HEART
RHYTHM (ARRHYTHMIA)
ECHOCARDIOGRAM
TO CHECK THE HEART VALVES FOR
ANY DAMAGE OR INFECTION AND
ASSESSING IF THERE IS HEART
FAILURE. THIS IS THE MOST USEFUL
TEST FOR FINDING OUT IF RHD IS
PRESENT.
ANTISTREPTOLYSIN O (ASO) TITER
A BLOOD TEST TO MEASURE
ANTIBODIES AGAINST
STREPTOLYSIN O, A SUBSTANCE
PRODUCED BY GROUP A
STREPTOCOCCUS BACTERIA.
 TREATMENT DEPENDS ON THE SEVERITY OF
TREATMENT: RHEUMATIC HEART DISEASE, BUT MAY INCLUDE:

HOSPITAL ADMISSION TO TREAT HEART FAILURE ANTIBIOTICS:

PENICILLIN OR ANOTHER
ANTIBIOTICS FOR INFECTION (ESPECIALLY OF
ANTIBIOTIC IS USUALLY GIVEN TO
THE HEART VALVES) - PENICILLIN G
KILL THE STREP BACTERIA.
BENZATHINE

BLOOD-THINNING MEDICINE TO PREVENT

ANTI-INFLAMMATORY:
STROKE OR THIN BLOOD FOR REPLACEMENT
VALVES
ASPIRIN OR NAPROXEN (NAPROSYN, NAPRELAN,
ANAPROX DS)
BALLOONS INSERTED THROUGH A VEIN TO
OPEN UP STUCK VALVES (BALLOON
VALVULOPLASTY)
ANTI-SEIZURE:

HEART VALVE SURGERY TO REPAIR OR REPLACE VALPROIC ACID OR CARBAMAZEPINE (CARBATROL,

DAMAGED HEART VALVES (OPEN HEART TEGRETOL, OTHERS)
SURGERY)
TREATMENT: ACCELERATED PROGRESSION DUE TO PREGNANCY

PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY

(PBMV):
A PROCEDURE IN WHICH A SMALL BALLOON IS INFLATED IN THE MITRAL VALVE TO HELP
KEEP IT OPEN
DIURETICS:

MEDICATIONS USED TO INCREASE

THE PRODUCTION AND EXCRETION
OF URINE, WHICH CAN HELP
DECREASE BLOOD VOLUME AND
BLOOD PRESSURE

BETA-BLOCKERS:
MEDICATIONS USED TO TREAT AND PREVENT
HEART ARRHYTHMIAS
PROGNOSIS
A SEQUELLAE OF ACUTE RHEUMATIC FEVER (ARF) THAT RESULTS IN LASTING HEART
VALVE DAMAGE IF UNTREATED [2], RHD IS TWICE AS COMMON IN WOMEN, MOST
LIKELY ASSOCIATED WITH SEVERAL FACTORS INCLUDING INCREASED RISK OF
AUTOIMMUNE DISEASE, ACCELERATED PROGRESSION OF MILD RHD DURING
PREGNANCY AND INCREASED EXPOSURE TO STREPA INFECTION. 80% OF PEOPLE WITH
RHD LIVE IN LOW-AND MIDDLE-INCOME COUNTRIES. EARLY DIAGNOSIS, CLOSE
FOLLOW-UP DURING PREGNANCY, EARLY RECOGNITION OF DETERIORATION IN
SYMPTOMS AND TIMELY CARDIAC INTERVENTION CAN LEAD TO GOOD MATERNAL OR
FETAL OUTCOME. PEOPLE WITH WELL-MANAGED RHEUMATIC HEART DISEASE CAN
ENJOY A HIGH QUALITY OF LIFE. THE RIGHT TREATMENTS MAY DELAY OR PREVENT
HEART FAILURE. BUT THE DISEASE IS PERMANENT AND REQUIRES LONG-TERM CARE.
THANK YOU
FOR LISTENING
Eunice Hil Arian V. Coscos
Qhyla Luaña