Disease Information for Rheumatic heart disease

Clinical Manifestations
Signs & Symptoms
Aortic systolic murmur
Cardiac auscultation/abnormal
Cardiac Symptoms/Signs
Heart murmur
Systolic murmur
Fair complexion/population/blond
Red Hair/Freckled fair complexion
Stroke syndrome/signs
Bronchospasm signs
Cough Dry Non-productive
Cough, nocturnal/supine
Clinical Presentation & Variations
Presentation/Congestive heart failure Child
Disease Progression
Heart Failure in Pregnancy
Demographics & Risk Factors
Ethnic or Racial Factors
Irish/Scotch population
Past History
Past history/Heart murmur/organic
Established Disease Population
Patient/Rheumatic fever
Patient/Atrial fibrillation poor rate control
Patient/Rheumatic valvular heart disease
Population Group
Family History
Family history/Rheumatic fever/heart disease
Family history/Heart disease
Sex & Age Groups
Population/Woman patient
Laboratory Tests
Abnormal Lab Findings - Increased
Anti-Myocardial Antibodies (AMA)
Diagnostic Test Results
EKG/P negative component V1/deep and long (ECG)
EKG/P Wave >2.5 msec wide V1,V2 (ECG)
EKG/P Wave M shaped/V1,2 (ECG)
EKG/P-Mitrale pattern (ECG)
EKG/Coarse atrial fibrillation pattern (ECG)
EKG/Left atrial hypertrophy signs (ECG)
Xray/Chest abnormal
Xray/Calcifications apparent/Chest
Xray/Chest/Lung fields/Abnormal
Xray/Kerley lines/Chest film
Xray/Calcified annulus fibrosis/Chest
Associated Diseases & Rule outs
Rule Outs
Atrial septal defect
Myocarditis, acute
Associated Disease & Complications
Aortic regurgitation
Aortic stenosis
Arterial Occlusion
Atrial fibrillation
Cerebral embolism
Cerebral vascular accident
Congestive heart failure
CVA Cardiac disorders/Cause
CVA Vascular disorders causes
Embolism, systemic/arterial
Endocarditis, infective
Left atrial hypertrophy
Mitral regurgitation
Mitral valve stenosis
Rheumatic heart disease
Stroke /Young adult
Tricuspid regurgitation
Tricuspid stenosis
Valvular heart disease
Heart Failure in a Child
Disease Mechanism & Classification
CLASS/Heart disorder (ex)
Pathophysiology/Hereditary disease/Adult manifestations
Pathophysiology/Arterial Occlusion
PROCESS/Complicating disorder (ex)
PROCESS/Post-infectious disorder (ex)
PROCESS/Structural/anatomic/foreign body (category)
Drug Therapy - Indication
RX/Prednisone (Deltasone)

Rheumatic heart disease refers to long term valvular disease [usually MS and AS] not specifically myocarditis or rheumatic fever, or bacterial endocarditis, although they may occur: Mitral stenosis: in temperate climates, a symptom-free period of 10 to 20 yr may follow recovery from rheumatic fever; symptoms of MS usually begin between ages 30 and 40; In tropical or subtropical countries, progression is swifter, often occurring in childhood; The first symptoms of MS are usually exertional dyspnea or fatigue; Frank pulmonary edema occurs with sudden elevations of left atrial pressure (eg, when uncontrolled atrial fibrillation produces too rapid a ventricular rate as an added insult to the loss of atrial contraction); Hemoptysis due to rupture of small pulmonary vessels and pulmonary edema is likely to occur with the increased blood volume in pregnancy; Emboli can occur in up to 15% of patients and are usually associated with atrial fibrillation but can occur in sinus rhythm; Left vocal cord paralysis (Ortner"s syndrome) can cause huskiness due to paralysis of the left recurrent laryngeal nerve, which is compressed when a dilated left atrium presses it against a dilated pulmonary artery; Significant MS is often found in patients with minimal or no symptoms; Lack of symptoms may, however, be due to subconscious modification of lifestyle; A plum-colored malar flush (mitral facies) is seen only with low CO and severe pulmonary hypertension; Left parasternal sustained movement may be significant (grade 2 to 4) due to RV hypertrophy and dilation or to a normal RV held against the sternum by a large left atrium; The S1 at the apex and the S2 may be palpable; -----------------------------------Aortic Stenosis: The classic triad of symptoms is syncope, angina, and dyspnea on exertion; If syncope occurs on exertion, it is considered to be due to fixed CO (inability to increase CO on exertion) and represents severe AS; Syncope may, however, be due to ventricular fibrillation unrelated to exertion


External Links Related to Rheumatic heart disease
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)