Download Rheumatic Heart Disease

Mitral Stenosis
The valve opening narrows,
impairing blood flow; the
valve does not open or close
properly.
Rheumatic Heart
Disease (RHD)
With chronic rheumatic heart
disease, patients develop
valve stenosis with various
degrees of blood reflux, atrial
dilation, arrhythmias, and
ventricular dysfunction.
The leading cause of mitral
valve stenosis and valve
replacement in adults in the
United States is Rheumatic
Heart Disease.
Process for development of
rheumatic heart disease
Cross-reactive antibodies bind to
cardiac tissue facilitating infiltration
of streptococcal-primed CD4+ T cells,
which then trigger an autoimmune
reaction releasing inflammatory
chemical
messengers
called
cytokines. Because few proteins that
stimulate the immune system (IL-4) –
producing cells are present in heart
valve tissue inflammation persists,
leading to valve lesions.
Burke, A. (2013). Pathology of rheumatic heart
disease. Retrieved from Medscape website:
emedicine.medscape.com/article/1962779-overview
Chin, T. K. (2012). Pedriatic rheumatic heart
Disease treatmetn & management Retrieve from:
Medscape website:
emedicine.medscape.com/article/891897-treatment
By: Amparo Elizabeth Bayless
Rheumatic
Heart Disease
DDiseasediseas
Rheumatic Heart Disease
Rheumatic heart disease is triggered by an autoimmune reaction to infection caused by group A
streptococci. The acute condition of heart inflammation involves inflammation of the myocardium,
endocardium and epicardium. Chronic disease appears with heart valve fibrosis, resulting in stenosis
and/or insufficiency. Rheumatic fever, the cause of rheumatic heart disease incidence, is most common
in children and adolescents. Symptoms may include difficulty breathing, exercise intolerance, rapid
heart rate, and a heart murmur. Diagnosed by ECG and findings of increased sedimentation rate (ERS).
in blood work.
RHD Cardiac
Manifestations
Valve deformities, blockage of blood vessels by
blood clots, cardiac hemolytic anemia, and
atrial arrhythmias are the most common
cardiac manifestations of chronic rheumatic
heart disease (CRHD).
Mitral stenosis occurs in 25% of patients with
CRHD and is associated with mitral valve
insufficiency in another 40%.
Aortic stenosis from CRHD is associated with
aortic insufficiency. The valve commissures and
cusps become adherent and fused.
Thromboembolism, blockage of blood vessels,
occurs as a complication of mitral stenosis. The
frequency of this complication has decreased
with the use of anticoagulants.
Cardiac hemolytic anemia is related to the
disruption of RBCs by a deformed valve.
Diagnosis
Made after confirming antecedent
rheumatic fever.
Rheumatic fever may occur following
group A beta hemolytic streptococcal
(GABHS) pharyngitis infection.
Rheumatic fever in adults with
streptococcal pharyngitis left
untreated with antibiotics has been
demonstrated.
Prevention and Treatment
Rheumatic heart disesae can be prevented by prompt treatment of A beta streptococcal
infections with penicillin. Prophylactic antibiotic treatment is recommended to reduce recurrence
of rheumatic fever, especially before dental or surgical procedures. Surgical repair or replacement
of affected valves as indicated . Aspirin therapy is used to manage inflammation.