Rheumatic Heart Disease

Question 1

What causes rheumatic heart disease?

Answer 1

A disordered immune response to a group A beta-haemolytic streptococcal infection

Question 2

What pathological changes does rheumatic fever cause in the body?

Answer 2

inflammatory changes in the heart and joints and sometimes also causes neurological symptoms

Question 3

Where in the world wold you find rheumatic fever?

Answer 3

the Middle East & Central Africa (it is now rare in Europe and North America)

Question 4

What demographic is most commonly affected by rheumatic fever?

Answer 4

children 5-15 years

boys>girls

Question 5

What are the major presenting features of rheumatic heart disease?

Answer 5

“flitting” (painful), polyarthritis of large joints (wrists, elbows, knees, ankles), skin rashes, fever, pancarditis, previous sore throat & heart murmurs

Question 6

What is pancarditis?

Answer 6

inflammation affecting endocardium, myocardium, pericardium

Question 7

Briefly explain the pathophysiology of rheumatic heart disease

Answer 7

The body’s strong antibody reaction to the strep may cross-react with unknown antigens in connective tissues and cause damage to heart tissue may be through a combination of antibody-mediated and T cell-mediated reactions

Question 8

What is the histological feature of acute rheumatic heart disease that can be found in the heart tissue ?

Answer 8

Aschoff Bodies

Question 9

What is an Aschoff body?

Answer 9

a focus of chronic inflammatory cells, necrosis and activated macrophages

Question 10

What kind of valvular disease is caused now almost exclusively by rheumatic heart disease?

Answer 10

Mitral stenosis