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Rheumatic Heart Disease I: Introduction

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...

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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...

Rheumatic Heart Disease III: Medical Management

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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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Severe Rheumatic Carditis in a High Resource Setting.

Jake Lesser¹, Heena Mansuri², Shanna Kowalsky-Herbst³

¹Department of Medical Education, Nicklaus Children's Hospital, Miami, Florida, USA.

JACC. Case Reports

|November 13, 2024

Summary

Acute rheumatic fever, though rare in the US, can lead to severe rheumatic heart disease even with prompt treatment. Early echocardiographic screening and monitoring are vital for preventing heart complications.

Keywords:

acute rheumatic fever pediatrics rheumatic heart disease

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Area of Science:

Pediatric Cardiology
Infectious Diseases
Rheumatology

Background:

Acute rheumatic fever (ARF) is an inflammatory condition following group A streptococcal infections.
Rheumatic heart disease (RHD) is a significant complication of ARF, affecting heart valves.
ARF incidence is low in developed countries like the U.S. but remains a global health concern.

Observation:

A 6-year-old boy presented with ARF subsequent to streptococcal pharyngitis.
Despite timely diagnosis and appropriate medical intervention, the patient experienced progressive RHD.
This case highlights the potential for severe outcomes even with standard care.

Findings:

The case underscores the unpredictable progression of RHD in pediatric patients.
Prompt diagnosis and treatment did not prevent the development of advanced cardiac damage.
Echocardiography played a role in assessing the extent of cardiac involvement.

Implications:

Timely diagnosis of ARF, supported by echocardiographic screening, is critical for early detection of cardiac involvement.
Vigilant follow-up care is essential to monitor for and manage RHD progression.
This case emphasizes the need for continued awareness and research into ARF and RHD management in low-incidence populations.