Rheumatic Heart Disease

Question 1

What is rheumatic fever?

Answer 1

disease of disordered immunity

inflammatory changes in the heart and joints, sometimes neurological symptoms

Question 2

Who does eheumatic fever effect?

Answer 2

5-15 years

boys

Question 3

What are the presenting features?

Answer 3

painful polyarthritis of large joints (wrists, elbows, knees, ankles) plus skin rashes and fever

Question 4

What does rheumatic fever effect?

Answer 4

pancarditis (inflammation affecting endocardium, myo and peri) in the acute phase; heart murmurs common

Question 5

patients have usually recently had a sore throats, but by what bacteria?

Answer 5

group A beta-haemolytic streptococcal infection

Question 6

What causes damage to heart tissue?

Answer 6

the group A beta-haemolytic streptococci

cause a strong ab reaction to the strep; may cross-react with unknown antigens in connective tissues

damage to heart tissue may be caused by combination of ab-mediated and T-cell mediated reactions

Question 7

What can rheumatic HD manifest as?

Answer 7

valvular abnormalities

Question 8

What does inflammation of endocardium and left sided valves result in?

Answer 8

fibrinoid necrosis of the valve cuss/chordae tendineae over which form small vegetations

Question 9

What valve is often involved in rheumatic HD?

Answer 9

mitral valve