Rheumatic Heart Disease Flashcards

1
Q

What is rheumatic fever?

A

A complication of untreated strep throat, can damage body tissue by causing them to swell

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2
Q

What is a complication of untreated strep throat that can damage body tissue by causing them to swell?

A

Rheumatic fever

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3
Q

Where is rheumatic fever common?

A

India

Middle East

Central Africa

(rare in Europe and North America)

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4
Q

Who does rheumatic fever commonly affect?

A

Children 5-15 years

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5
Q

Does rheumatic fever affect more boys or girls?

A

Boys

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6
Q

What does rheumatic fever lead to?

A

Inflammatory changes in the heart and joints, sometimes neurological symptoms

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7
Q

What are the presenting features of rheumatic fever?

A

Flitting (painful)

Polyarthritis of large joints (wrist, elbows, knees, ankles)

Skin rashes

Fever

Pancarditis in the acute phase

Heart murmurs are common

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8
Q

What is pancarditis?

A

Inflammation affecting endocardium, myocardium and pericardium

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9
Q

What have most patients who have rheumatic fever recently had?

A

Sore throat usually due to group A beta-haemolytic streptococcal infection

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10
Q

Why does the untreated strep lead to rheumatic fever?

A

Strong antibody reaction to strep may cross react with unknown antigens in connective tissue leading to damage to heart tissue caused by antibody and T cell mediated reactions)

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11
Q

Histologically, what is seen in the heart in rheumatic fever?

A

Aschoff body

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12
Q

What is valvular heart disease characterised by?

A

Damage to or a defect in one of the four heart valves

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13
Q

What are examples of valvular heart disease?

A

Valvular stenosis

Valvular incompetence

Vegetations

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14
Q

What is valvular stenosis?

A

Valve thickened/calcified and obstructs normal blood flow into chamber/vessel

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15
Q

What is it called when valve is thicken/calcified and obstructs the normal blood flow into chamber/vessel?

A

Valvular stenosis

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16
Q

What is valvular incompetence?

A

Valve loses normal function and fails to prevent reflux of blood after contraction of cardiac chamber

17
Q

What is it called when valve loses normal function and fails to prevent reflux of blood after contraction of cardiac chamber?

A

Valvular incompetence

18
Q

What is valvular vegetations?

A

Infective or thrombotic nodules develop on valve leaflets impairing normal valve mobility, they may embolism

19
Q

What are infective or thrombotic nodules develop on valve leaflets impairing normal valve mobility that may embolise called?

A

Valvular vegetations

20
Q

What is rheumatic heart disease?

A

A complication of rheumatic fever in which the heart valves are damaged

21
Q

How does rheumatic fever become rheumatic heart disease?

A

Pancarditis in acute rheumatic fever can progress over time to chronic rheumatic heart disease where it mainly manifests as valvular abnormalities

22
Q

Why does rheumatic heart disease manifest as valcular abnormaliies?

A

Inflammation of the endocardium and left sided valves results in fibrinoid necrosis of the valve cusps/chordae tendinae over which form small vegetations

23
Q

What is rheumatic heart disease characterised by?

A

Fibrotic valvular disease, particularly involving the mitral valve

24
Q

What is virtually the only cause of mitral stenosis?

A

Rheumatic heart disease

25
Q

Can rheumatic heart disease cause aortic stenosis?

A

Rarely, mostly due to calcific aortic valve disease

26
Q

How common is the tricuspid and pulmonary valve involvement in rheumatic heart disease?

A

Tricuspid is infrequent

Pulmonary is rare