Rheumatic Heart Disease Flashcards
Describe rheumatic fever.
Rheumatic fever is a disease of disordered immunity that causes inflammatory changes in the hearts and joints, along with sometimes neurological symptoms.
What age group does rheumatic fever commonly affect?
Rheumatic fever commonly affects children between five and 15 years of age.
What are the main presenting features of rheumatic fever?
The main presenting features of rheumatic fever include flitting painful polyarthritis of large joints, skin rashes, fever, and pancarditis.
How is rheumatic fever usually triggered?
Rheumatic fever is usually triggered by a recent sore throat, often due to group A beta-haemolytic streptococcal infection.
Define pancarditis in the context of rheumatic fever.
Pancarditis in rheumatic fever refers to inflammation affecting the endocardium, myocardium, and pericardium in the acute phase, often leading to heart murmurs.
Describe the components of an Aschoff body in acute rheumatic fever.
Inflammatory cells, necrosis, and activated macrophages (Anitschkow cells).
Define valvular stenosis in the context of valvular heart disease.
Thickening and/or calcification of the valve leading to obstruction of normal blood flow into the chamber or vessel.
How does valvular incompetence differ from valvular stenosis in heart disease?
Valvular incompetence refers to the valve losing its normal function and failing to prevent reflux of blood after contraction of the cardiac chamber, while stenosis involves obstruction of blood flow.
Describe vegetations in the context of heart valve abnormalities.
Vegetations are infective or thrombotic nodules that develop in valve leaflets, impairing normal valve mobility and potentially causing embolism.
Explain the progression from acute rheumatic fever to chronic rheumatic heart disease.
Pancarditis in acute rheumatic fever can evolve into chronic rheumatic heart disease, often leading to valvular abnormalities due to inflammation and fibroid necrosis of valve cusps and chordae tendineae.
Describe the characteristics of rheumatic heart disease involving mitral valve.
It is characterized by leaflet thickening, commissural fusion, shortening, and thickening fusion of the chordae tendineae.
What is the primary cause of mitral stenosis nowadays?
Rheumatic heart disease is virtually the only cause of mitral stenosis now.
How is major regurgitation commonly caused nowadays?
Major regurgitation is most commonly due to ischemic heart disease.
Define the main cause of aortic stenosis nowadays.
Most cases of aortic stenosis are due to calcific aortic valve disease.
Describe the involvement of the tricuspid valve in rheumatic heart disease.
Tricuspid valve involvement is infrequent in rheumatic heart disease.
