Rheumatic Heart Disease

Answer 1

Rheumatic Heart disease is another name for rheumatic fever, a disease which largely afflicts children between the ages of 6-15. The causative agent is due to a bacterial infection, Strepococcus pyogenes. Though common worldwide, this condition is fairly rare in developed countries, such as the U.S and the U.K., due to the advent and widespread use of antibiotics after the 1960s. However, it is a serious condition that can lead to serious and potentially debilitating heart disease later in life.

Rheumatic heart disease is characterized by a set of signs and symptoms. Not all of the signs and symptoms have to be present in order to have rheumatic heart disease. The major criteria for rheumatic heart disease includes:

1. Polyarthritis - inflammation and pain in the joints, usually ascending, starting from the lower joints
2. Carditis - inflammation of the heart, causing acute heart failure, resulting in pain, shortness of breath and abnormal heart sounds.
3. Subcutaneous nodules - firm, nontender nodules over the tendons of the body.
4. Erythema marginatum - a circular rash, never on the face, that spreads in a snake-like fashion, clears in the middle and worsens with heat.
5. Sydenham's chorea - a series of rapid movements and jerks in the arms and face without voluntary control.

Though not all of the symptoms have to be present to have this condition, having two of these symptoms is diagnostic of this disease. In addition, only having one of these symptoms as well as several minor other symptoms can be diagnostic of rheumatic heart disease. Its name, rheumatic heart disease, comes from the fact that many of its symptoms are similar to rheumatic disorders, such as rheumatic Arthritis and other inflammatory joint conditions.

In terms of the heart, rheumatic heart disease can cause acute signs of congestive heart failure, which is typically uncommon in children. Medically, it is treated similarly to heart failure in adults, which means diuretics and digoxin. However, corticosteroids, which are not used in typical heart failure, are of great benefit because it tunes downs the inflammation response which causes a lot of the symptoms. Though easily treated with antibiotics, treatment should attempt to prevent the formation of thickened leaflets in the heart valve and inflammatory changes that causes dysfunction of the heart valves. Such changes predispose people towards developing congestive heart failure in the future, as well as a potential second attack. In such affected people, low-dose antibiotics like penicillin are required for three to five years after the first attack to prevent future attacks.