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Rheumatic Heart Disease I: Introduction01:23

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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...
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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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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...
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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...
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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
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Acute Rheumatic Carditis: A Rare Cause for Reversible Complete Heart Block.

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Acute rheumatic carditis can cause severe heart block in young adults. Prompt treatment with antibiotics and anti-inflammatories can reverse this conduction system damage, avoiding permanent pacemakers.

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Area of Science:

  • Cardiology
  • Rheumatology
  • Pediatric Cardiology

Background:

  • Acute rheumatic carditis is a rare but serious complication of streptococcal infection.
  • It can affect the heart's electrical conduction system, leading to heart block.

Observation:

  • An 18-year-old male presented with fever, weakness, and joint pain.
  • He was diagnosed with complete heart block and transient asystole, requiring transvenous pacing.

Findings:

  • The heart block was attributed to acute rheumatic carditis.
  • Conduction system function improved with Penicillin and high-dose Aspirin therapy.
  • Permanent pacemaker implantation was not necessary.

Implications:

  • Acute rheumatic carditis can manifest with significant conduction abnormalities.
  • Early diagnosis and treatment are crucial for reversible cardiac outcomes.
  • This case highlights the importance of considering rheumatic carditis in young patients with unexplained heart block.