Acute rheumatic fever and rheumatic heart disease

acute-rheumatic-fever-and-rheumatic-heart-disease

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Regarding Acute rheumatic fever it is a nonsuppurative consequences of a pharyngeal infection by

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It is a nonsuppurative consequence of a pharyngeal infection by group A Beta hemolytic streptococcus (Strep pyogenes). It commonly occurs 2-3 weeks after throat symptoms in 3-6% of the cases due to immune cross reactivity between the bacteria and the connective tissue. This is disease of the poor, the overcrowded and the poorly housed. The presence of severe disease tends to reflect recurrent episodes of acute rheumatic fever. In most patients with carditis, if the recent attacks could be prevented they would eventually lose their murmur and the heart would return to normal or near normal. Worldwide an estimated 10-20 million people get acute RF yearly. Rheumatic heart disease is the most common cause of valvular heart disease in the world. Most common in children ages 4-9 years old, but adults can get acute rheumatic fever also.

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Acute rheumatic fever occurs.........after throat symptoms in........% of the cases due to immune cross reactivity between bacteria and the connective tissue.

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Acute rheumatic fever is disease of the

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This is disease of the poor, the overcrowded and the poorly housed. The presence of severe disease tends to reflect recurrent episodes of acute rheumatic fever. In most patients with carditis, if the recent attacks could be prevented they would eventually lose their murmur and the heart would return to normal or near normal. Worldwide an estimated 10-20 million people get acute RF yearly. Rheumatic heart disease is the most common cause of valvular heart disease in the world. Most common in children ages 4-9 years old, but adults can get acute rheumatic fever also.

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The presence of severe disease tends to reflect recurrent episodes of acute rheumatic fever

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In most patients with carditis, if the recent attacks could be prevented they would eventually lose their murmur and the heart would return to normal or near normal

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Acute rheumatic fever is most common in children ages

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The clinical diagnosis of Acute rheumatic fever is made by

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Clinical diagnosis: Jones Criteria: 2 major criteria OR one major + 2 minor criteria AND evidence of recent streptococcal infection. Major Criteria  Carditis: Occurs in about 50% of the cases and is the most serious manifestation of RF. It may affect only the endocardium, or it can affect all layers of the heart (pericardium to the endocardium). This acute presentation is different from the later sequelae of rheumatic heart disease (mitral stenosis). Congestive heart failure symptoms tend to represent advance disease.  Arthritis: Occurs in 80% of the cases. Migratory polyarthritis usually of large joints. each affected joint inflamed for less than one week and typically over 6 joints involved  Chorea: also called Sydenham chorea or St. Vitus dance is seen in 10% of the patients. It’s abrupt, purposeless, nonrhythmic, involuntary movements, usually worse on one side. Chorea can occur up to 8 months after strep infection  Subcutaneous nodules: Firm, painless, non-inflamed, variable in size, symmetric when multiple and located over bony surfaces or near tendons, appear earlier in course of ARF and usually only in patients with carditis. This presentation is rare.  Erythema marginatum: pink, evanescent, non-itchy rash on trunk and limbs, but not on face. Heat brings lesions out. Seen in < 5% of the cases.

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Jones criteria for diagnosis of Acute rheumatic fever

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Jones criteria for acute rheumatic heart disease

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JONES CAFEPAL

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Minor

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Differential diagnosis of rheumatic fever

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ROSSE

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Antibodies are better than culture because the culture is often............

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**Antibodies are better than culture because the culture is often negative. Antibody titer usually peaks at 4-5 weeks after pharyngitis. Cannot use titers as indicator of disease activity after initial illness.

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Antibody titer usually peaks at......... after pharyngitis.

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Can use titers as indicator of disease activity after initial illness

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Rheumatic heart disease occurs.......after original attack.

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Rheumatic heart disease occurs 10-20 years after original attack. This is why the peak incidence of rheumatic heart disease is 15 – 30 years of age (since the peak age for acute rheumatic fever is at 4- 9 years of age). Probably develops in over 50% of patients with initial carditis due to acute rheumatic fever. Severe rheumatic heart disease usually only occurs after multiple episodes of acute rheumatic fever. Recurrent episodes of inflammation lead to chronic fibrosis and then calcification of the valves. This is why antibiotic prophylaxis after a first episode of acute rheumatic fever is so important.

Acute rheumatic fever and rheumatic heart disease

Question 1 of 1

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Regarding Acute rheumatic fever it is a nonsuppurative consequences of a pharyngeal infection by

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Explanation

Acute rheumatic fever occurs.........after throat symptoms in........% of the cases due to immune cross reactivity between bacteria and the connective tissue.

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Explanation

Acute rheumatic fever is disease of the

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The presence of severe disease tends to reflect recurrent episodes of acute rheumatic fever

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In most patients with carditis, if the recent attacks could be prevented they would eventually lose their murmur and the heart would return to normal or near normal

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Acute rheumatic fever is most common in children ages

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The clinical diagnosis of Acute rheumatic fever is made by

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Jones criteria for diagnosis of Acute rheumatic fever

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Jones criteria for acute rheumatic heart disease

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Differential diagnosis of rheumatic fever

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Antibodies are better than culture because the culture is often............

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Antibody titer usually peaks at......... after pharyngitis.

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Can use titers as indicator of disease activity after initial illness

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Rheumatic heart disease occurs.......after original attack.

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The peak incidence of rheumatic heart disease is.........of age.

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