Rheumatic fever and heart disease

Question 0

Etiology of Rheumatic Fever

Answer 0

Usually develops two weeks after an acute episode of strep throat (streptococcal infection)
Antibodies developed against the strep ntigens attack self antigens found in the heart, brain, muscle, joints
Heart disease (scarring and deformity of heart valves) occurs in 10% of cases

Question 1

Rheumatic fever

Answer 1

A systemic, immunologically mediated disease related to streptococal infections
Incidence decreasing due to antibiotics

Question 2

Pancarditis includes

Answer 2

Endocarditis - includes valvular defects
Myocarditis - common, can include arrhythmia, cardiac conduction problems
Pericarditis - only in severe cases

Question 3

Clinical manifestation of Rheumatic fever

Answer 3

Sore throat,
Pharyngitis
carditis
acute migratory polyarthritis
Chorea (Sydenham’s chorea or St. Vitus’ dance)
SOB
Nocturnal cough
Rash (erythema marginatum - pink ring rim rash)
Subcutaneous nodule
Fever, malaise, weakness, weight loss, anorexia

Question 4

Diagnosis of Rheumatic fever

Answer 4

Clinical manifestation,
Throat culture
ECHO

Question 5

Treatment of Rheumatic fever

Answer 5

Antibiotics
Antiinflammatories
Corticosteroids
CNS depressant
Surgery

Question 6

Prognosis of Rheumatic fever

Answer 6

Initial episodes last weeks to months
20% of cases recur
Heart damage occasional complication
Mortality is low

Question 7

Infection or inflammation of endocaridum

Answer 7

Endocarditis

Question 8

Etiology of Endocarditis

Answer 8

Bacterial infection particularly staphylococci and streptococci
Can occur at any age
Men > Women (2X)

Question 9

Risk factors

Answer 9

Damaged valves
IV drug users
Immunocompromised