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11.6.10

Rheumatic Heart Disease


Rheumatic Heart Disease involves the heart after rheumatic fever that causes cartidis.

Rheumatic fever:
Rheumatic fever is a systemic sequela of streptoccocal infection.It may be acute severe(occasionally0 or subacute(commomnly) and may become chronic.
Causes:
Rheumatic fever is a clinical syndrome that fallows Streptococcus Pyogenes infection,after a latent period of 2-3 weeks.It is autoimmune disease that represents hypersensitivity reaction to streptococcal infection.
Incidence:Rheumatic fever is commonly a problem of children and adolescents of 5-15 years,with varied incidence.

Predisposing factors:
-Insanitary environment:poor housing,slum areas,with high crowdness index,crowded badly ventilated classrooms.bedroos and other confined places,faulty habits that favour spred of infection
-Frequent exposure to streptococcal pharyngitis since causative organism has a big number of serptypes.
-Cases of sterptococcal pharyngitis not or improperly given chemotheraphy.
-Host factors:poor living conditions,inheritance.

Characteristics:
-sudden onset of fever,anorexia,epistaxis and precordial and abdominal pain.
-inflammtory involvement of different parts of the body
-case eventually subsides but is more susceptible to repeated attacks of rheumatic fever on repeated streptococcal infection and development of rheumatical heart disease.

Prevention of Rheumatic Fever:
I.Primary prevention:
1.General mesasures:
-community and socioeconomic development with sanitary housing and living conditions
-health promotion,including adequate nutrition.
2.Prevention of streptococcal infection,specially in confined groups of children and adolescents,in schools,institutes and camps.
3.Control of streptococcal disease,specially pharyngitis.

II.Secondary prevention;
Those who have suffered an attack of rheumatic fever must be protected by chemoprophylaxis,against streptococcal infection and recurrent rheumatic fever(given later).