(P4) Cardiac: Rheumatic Myocarditis Flashcards
- identify slide*
- Define the cause;*
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Rheumatic myocarditis
Rheumatic fever is an acute, immunologically mediated, multisystem inflammatory disease that occurs after group A β‐hemolytic streptococcal infections (usually pharyngitis, but also occasionally infections at other sites, such as skin)
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Identify Slide
Cardiac manifestation is called?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/249/755/q_image_thumb.png?1613242994)
Rheumatic myocarditis
rheumatic heart disease
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/249/755/a_image_thumb.png?1613243033)
Morphological presentation of
Rheumatic myocarditis is?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/249/933/q_image_thumb.png?1613243130)
– Pericarditis – Miocarditis – Endocarditis
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Rheumatic myocarditis
The diagnosis of acute rheumatic fever is made based on serologic evidence of?
previous streptococcal infection in conjunction with two or more of the Jones criteria:
– carditis
– migratory polyarthritis of large joints
– subcutaneous nodules
– erythematous annular rash (erythema marginatum) in the skin
– Sydenham chorea
Sydenham chorea (SC) is a neurological disorder of childhood resulting from infection via Group A beta-hemolytic streptococcus (GABHS), the bacterium that causes rheumatic fever. SC is characterized by rapid, irregular, and aimless involuntary movements of the arms and legs, trunk, and facial muscles
- Rheumatic myocarditis*
- Minor criteria* such as?
fever, arthralgias, EKG changes,
or
elevated acute phase reactants
Rheumatic myocarditis
Micro:
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/250/504/q_image_thumb.png?1614628001)
– Nonspecific myocarditis, in which lymphocytes and macrophages dominate, although a few neutrophils and eosinophils may be evident.
– The Aschoff’s body is the typical lesion of r_heumatic myocarditis_, the structure initially consists of perivascular focus of fibrinous necrosis surrounded by lymphocytes, plasma cells and plump macrophages (Anitschkow bodies)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/250/504/a_image_thumb.png?1614627988)
identify slide and structure
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![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/250/911/a_image_thumb.png?1613243885)
Rheumatic myocarditis
identify slide and structure
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/250/992/q_image_thumb.png?1613243962)
Rheumatic myocarditis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/250/992/a_image_thumb.png?1613244012)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/251/049/q_image_thumb.png?1613244085)
Rheumatic myocarditis
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1. Aschoff bodies: nodule in RF with macrophages, giant cells, Anitschkow cells*
2. Anitschkow cells: enlarged macrophages characteristic of RF*
3. lipofuscin*
4. joints, skin, CNS
Rheumatic myocarditis
Cause?
Infection by bacteria Strep A:
laryngitis, pharyngitis, upper respiratory infection
Rheumatic myocarditis
Which organs are affected in teh course of this disease apart form that seen on the slide:
3 Examples?
joints
skin
CNS
Rheumatic myocarditis
Is a cross reaction between what?
Cross reaction between streptococci’s protein M and glycoprotein in the heart, joints and other tissues
define
Aschoff bodies
Small granules surrounding blood vessels (accumulation of cells around vessel)
-with time completely obliterate vessel and develop foci of necrosis
Antischkow cells are?
Antischkow cells
are
enlarged macrophages found within granulomas (Aschoff bodies)
Identify slide
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/252/109/q_image_thumb.png?1613245025)
Rheumatic myocarditis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/336/252/109/a_image_thumb.png?1613245043)