Rheumatic Fever and Heart Disease

Question 1

Rheumatic Fever

Answer 1

An inflammatory disease that may affect several connective tissues, such as heart, brain, joints or skin
Result of rheumatic fever -> characterized by scarring & deformity of heart valves)
Involves all layers of the heart (endo, myo, and pericardium)

Question 2

Acute rheumatic fever (ARF) is a complication of

Answer 2

A streptococcal pharyngitis (strep throat)

Question 3

40% of ARF episodes are marked by

Answer 3

carditis - inflammation of the heart

Question 4

Rheumatic endocarditis

Answer 4

Swelling & erosion of valve leaflets, on which vegetations form (deposits of fibrin & blood) -> thickening of valves and fusion of commissures and chordae tendineae -> valves become thickened and calcified -> stenosis. Reduction of mobility with failure of valves -> regurgitation

Question 5

Clinical Manifestations (5)

Answer 5

Chest pain
Excessive fatigue
Heart Palpitations
Dyspnea
Swollen ankles, wrists or stomach

Question 6

Major Criteria (4)

Answer 6

Carditis
Mono- or polyarthritis
Chorea (sydenham chorea) - involuntary movement disorder caused by overactivity of the neurotransmitter dopamine
Erythema marginatum (skin rash)

Question 7

Equation to diagnose ARF

Answer 7

The presence of 2 major criteria, or 1 major & 2 minor criteria plus A streptococcal infection -> high probability of ARF

Question 8

Minor criteria

Answer 8

Clinical findings: fever, polyarthralgia
Laboratory findings: increased ESR, WBC, CRP
ECG findings: prolonged PR interval