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matic
Heart
Diseas
e
Carl Stephen B. Perez, RN
I.
Definition
A systemic inflammatory disease of childhood, acute rheumatic fever develops after
infection of the upper respiratory tract with Group A Beta- Hemolytic streptococci.
Rheumatic fever principally involves the heart, joints, CNS (Central Nervous System), skin,
subcutaneous tissues.
The term Rheumatic heart disease refers to the cardiac involvement develops to 50% of
patients and may affect the endocardium, myocardium or pericardium. It may later affect
the heart valves, causing chronic valvular disease.
The extent of damage to the heart depends on where the disorder strikes.
*Endocarditis- causes valve leaflet, swelling, erosion along the lines of leaflet closure and
blood, platelet and fibrin deposits, which form beadlike vegetation.
A narrowed or stenotic valve requires the heart to pump harder, which can strain the
heart and reduce blood flow to the body.
A regurgitant (incompetent, insufficient, or leaky) valve does not close completely,
letting blood move backward through the valve.
IV. Pathophysiology
Poly arthritis- sharp, sudden pain starts over sternum and radiates to neck, shoulders,
back and arms.
Erythema marginatum- a non- pruritic, muscular, transient rash.
Subcutaneous nodules- a firm, movable, non-tender and about 3 mm-2 cm in diameter.
Transient chorea- involuntary grimace and an inability to use skeletal muscles in a
coordinated manner.
Heart murmur
CHF
There is no diagnostic studies are specific for rheumatic heart disease, but the following
can support the diagnosis:
WBC count and ESR is elevated
C- reactive protein is positive.
Cardiac enzmes levels may increase in severe carditis.
Anti streptolysin- O titser is elevated 95% of patients with in 2 months onset.
Throat cultures continue to presence of GABS; however they usually occur in small
numbers. Isolating them is difficult.
ECG reveals no diagnostic changes, but 20% of patient show a prolonged PR interval.
Echocardiography helps evaluate valvular damage, chamber size, ventricular function and
the presence of a pericardial effusion.
Cardiac catheter evaluates valvular damage and left ventricular function in severe cardiac
dysfunction.
Valvuloplasty procedure to improve blood flow through a narrow valve with the use of a
catheter
Valve replacement
Name: ______________________________________
Date: __________________
a. GABS
b. Pseudomonas
c. Retrovirus
d. None of the above
3. What causes valve leaflet, swelling,
erosion along the lines of leaflet closure
and blood, platelet and fibrin deposits,
which form beadlike vegetation?
a. Endocarditis
b. Tubercolosis
c. Lung Cancer
d. Heart Failure
4.