Disease Information for Rheumatic heart disease

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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
Cough Dry Non-productive
Cough, nocturnal/supine
Wheezing
Clinical Presentation & Variations
Presentation/Congestive heart failure Child
Disease Progression
Heart Failure in Pregnancy
Demographics & Risk Factors
Ethnic or Racial Factors
Arab/population
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
Woman
Family History
Family history/Rheumatic fever/heart disease
Family history/Heart disease
Sex & Age Groups
Population/Female
Population/Woman patient
Laboratory Tests
Abnormal Lab Findings - Increased
Anti-Myocardial Antibodies (AMA)
Diagnostic Test Results
EKG (ECG)
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)
X-RAY
Xray/Cardiomegaly/Chest
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
Cardioembolism
Heart Failure in a Child
Disease Mechanism & Classification
Class
CLASS/Heart disorder (ex)
Pathophysiology
Pathophysiology/Hereditary disease/Adult manifestations
Pathophysiology/Arterial Occlusion
Process
PROCESS/Complicating disorder (ex)
PROCESS/Post-infectious disorder (ex)
PROCESS/Structural/anatomic/foreign body (category)
Treatment
Drug Therapy - Indication
RX/Prednisone (Deltasone)
Definition

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

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