RHD And VHD

Question 1

What is acute rheumatic fever?

Answer 1

It’s an autoimmune inflammatory response that develops due to a streptococcal infection , likely due molecular mimicry
Infection involves carditis , skin and joints
May lead to rheumatic heart disease

Question 2

What is the treatment of rheumatic fever with carditis?

Answer 2

Long acting penicillin G for 10 years (injection) , unless there is a oenicillin allergy

Question 3

What are the complications RHD?

Answer 3

• valve stenosis
• valve regurgitation
• damage to heart muscles;
  Pericarditis , myocarditis, vulvitis /endocarditis or law kolo together pancarditis (acute) -> chronic valvular disease progressing to arthymia and heart failure so yehsal valvular heart disease secondary to rheumatic heart disease

Question 4

What is valve stenosis?

Answer 4

Valve doesnt open properly , diseased fibrotic valve so less blood goes too the next chamber and more blood than normal stays in the first chamber

Question 5

What is valve regurgitation?

Answer 5

Valve does not close properly , so blood will trickle back causing murmur and turbulence,
More and more blood causes more load causes hypertropgy then heart failure

Question 6

Symptoms or clinical picture of RHD?

Answer 6

• dyspnea
• palpitations ( awareness of heart rate due to rhythm or rate changes)
• cardiac murmur
• sot gharib when blood is travelling through stenosed valve

Question 7

How to diagnose RHD or VHD?

Answer 7

• auscultation reveals cardiac murmur
• eco can be used to define the type of valve lesion and its extent
  Can also show hypertrophy of the heart muscles
  Transthoracic or trans esophogeal eco have higher accuracy
• this all will determine if surgical correction is needed for valve

Question 8

Treatment of RHD?

Answer 8

• protection against rheumatic fever via long acting penicillin G for 10 years
• prevent infective endocarditis
• valve replacement if severe

Question 9

Problem that can arise with mechanical valve replacement?

Answer 9

• foreign body so body may have an immune response aka huge thrombus fo2 el valve that’s why patient has to take anticoagulant for life
• way more at risk for infective endocarditis

Question 10

What is congenital hearty disease?

Answer 10

• structural abnormalities of the heart that form in utero
• very large spectrum of severity, can be asymptomatic and can be life threatening
• classified into cyanotic (blue) and acynotic

Question 11

What is the tetralogy of fallot?

Answer 11

They are congenital cyanotic heart defects:
- ventricular septal defect: hole in ventricular septum , oxygenated and deoxygenated blood are mixed
- pulmonary stenosis (narrowing of the blood vessels supplying the lung)
- a misplaced aorta: takes blood from the wrong ventricle therefore delivers deoxygenated blood (takes from both)
- right ventricular hypertrophy

Question 12

Acynotic heart diseases?

Answer 12

Don’t effect oxygen or blood supply but affect how the blood flows, abnormal
- atrial septum defect
- ventricular septum defect
- Patent ductus arteriosis (vessel connecting aorta and pulmonary artery)

Question 13

What are complications of congenital and rheumatic valvular heart disease?

Answer 13

• heart failure
• infective endocarditis
• arthymia
• embolisation (due to turbulence men valve disease, can cause a stroke or embolus f ay heta fel gesm or if the turbulence is in the right ventricle to can cause a pulmonary embolism)