Rheumatic fever Flashcards
Multisystem autoimmune inflammatory disease with major cardiac manifestations
Rheumatic fever
Rheumatic fever most often affects
children 5-15
Rheumatic fever occurs after an infection caused by
group A streptococci
(Not bacterial! - autoimmune disease)
AN elevated __ is evidence of a recent streptococcal infection
antistreptolysin O titer
T/F: RF is a result of a bacterial infection
FALSE! it is not
RF is an example of a __
type II hypersensitivity reaction (to the antibodies produced from group A streptococci)
The patients immune response is unable to distinguish between the strep and host tissues resulting in an ___ tissue injury, characterized by nonsuppurative inflammatory lesions of the __
auto-immune mediated tissue injury
joints, heart, subcutaneous tissue, CNS
The __ is the classic, myocardial lesion of RF
aschoff body
Describe the aschoff body/nodule
large activated macrophages
antischkow cells
multinucleated giant cells - aschoff cells
__ occurs in up to 40% OF PATIENTS WITH RF AND CONSISTS OF INFLAMMATION OF THE PERICARDIUM, MYOCARDIUM AND ENDOCARDIUM
Carditis (pancarditis)
Pericarditis
Myocarditis (congestive heart failure - cause of most deaths)
Endocarditis (valvular damage)
Rheumatic endocarditis usually occurs in areas subject to greatest hemodynamic stress such as the posits of
valve closure
Noncardiac manifestations of RF
Fever and increased ESR
Joint involvement
Skin lesions
CNS involvement
Noncardiac manifestations of RF:
Joint involvement
Migratory polyarthritis (occurs in 75% of patients)
Noncardiac manifestations of RF:
Skin lesions
subcutaneous nodules (10%)
erythema marginatum (5%)
Noncardiac manifestations of RF:
CNS involvement
Sydenham’s chorea (St. Vitus’s dance)
Results from single or repeated attacks of RF and consists of the cardiac valve damage (chronic valvulitis) that often occurs many years after the episodes of RF
Chronic rheumatic heart disease
Due to fibrotic healing, valves become thickened, fibrotic, rigid and deformed with thickening of chordae tendineae
Chronic rheumatic heart disease
The __ is the valve most frequently involved in RHD resulting in a fishmouth or buttonhole deformity
Mitral valve
When the tricuspid valve is affected it is always in conjunction with the
mitral valve and aortic valves
The __ can be affected by stenosis or insufficiency
aortic valve
