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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
Hypersensitivity Reactions: Immune-Complex Reactions01:19

Hypersensitivity Reactions: Immune-Complex Reactions

Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum sickness, a systemic...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...

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Related Experiment Video

Updated: Jun 3, 2026

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
07:37

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice

Published on: June 6, 2025

Rheumatic heart disease: mediation by complex immune events.

L Guilherme1, K F Köhler, J Kalil

  • 1Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil. luizagui@usp.br

Advances in Clinical Chemistry
|March 17, 2011
PubMed
Summary
This summary is machine-generated.

Rheumatic fever susceptibility involves molecular mimicry between Streptococcus pyogenes and human proteins. A skewed Th1/Th2 cytokine balance, with low IL-4 in valves, contributes to chronic rheumatic heart disease.

Related Experiment Videos

Last Updated: Jun 3, 2026

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
07:37

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice

Published on: June 6, 2025

Area of Science:

  • Immunology
  • Cardiovascular Medicine
  • Microbiology

Background:

  • Rheumatic fever (RF) is an autoimmune disease triggered by Streptococcus pyogenes infection.
  • Rheumatic heart disease (RHD), a severe complication, causes chronic valvular damage in 30-45% of RF patients.
  • Genetic susceptibility plays a role in RF and RHD development.

Purpose of the Study:

  • To investigate genes conferring susceptibility to RF and RHD.
  • To understand the role of molecular mimicry in RHD pathogenesis.
  • To analyze the involvement of T cell responses and cytokine profiles in RHD.

Main Methods:

  • Identification of autoantigens involved in molecular mimicry.
  • Analysis of T cell populations (CD4+) and their cytokine production (TNF-alpha, IFN-gamma, IL-4) in heart tissue.
  • Comparison of cytokine profiles in myocarditis and valve lesions.

Main Results:

  • Molecular mimicry involves cross-reactions between streptococcal antigens and human proteins like cardiac myosin and vimentin.
  • Antigen-driven CD4+ T cell expansions producing TNF-alpha and IFN-gamma are implicated in rheumatic heart lesions.
  • While IL-4 producing cells are present in the myocardium, they are scarce in RHD valve lesions.

Conclusions:

  • The Th1/Th2 cytokine balance is crucial for resolving myocarditis in RF.
  • Low levels of IL-4 in RHD valve lesions likely contribute to progressive and irreversible valvular damage.
  • Understanding these immune mechanisms may inform RHD prevention and treatment strategies.