Rheumatic Heart Disease (Cardiac Diseases)

Question 1

rheumatic heart disease (RHD)

Answer 1

• part of rheumatic fever (RF)
• must have RF to get RHD
• mostly occurs in children
• preceded by strep throat or genetic
• molecular mimicry
• systemic effects (Abs target Ags in heart, joints, CNS, integument)
• infection in pharynx not heart
• inflm of valves, myocardium, and pericardium
• chronic RHD leads to severe heart damage

Question 2

molecular mimicry in RHD

Answer 2

• normally, child has strep throat, T cells and Abs form and an infection is eradicated by defense cells
• however, if child pre-disposed to molecular mimicry, the child’s Abs that were created to eradicate strep throat will begin to attack self-Ags (occurs 1 week after infection)

Question 3

acute form of RHD

Answer 3

• self-limiting (heals on its own)

- continue to monitor and Tx as symptoms arise

Question 4

Mnfts

Answer 4

• general cold/cough
• valvular dysFx (d/t inflm near chordae tendinae) r/t in:
• SOBOE, weakness, fatigue, edema, chest pain

Question 5

Dx

Answer 5

• Dx strep throat first (throat swab), however, this infec may have cleared by time RHD symptoms arise
• non-specific tests: CBC, ESR, CRP, Differential
• Dx complex b/c no specific tests can be done & symptoms child has very general
• no CKMB released b/c no necrosis of tissue

Question 6

Tx

Answer 6

• prompt Dx and Tx of strep throat
• erythromycin and penicillin (Abx) + anti-inflammatories
• BED REST key to recovery to dec workload
• symptomatic management –> handle cardiac cmplx