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BREATHING THROUGH A FISH MOUTH (3 months of dyspnoea and intermittent…

- - - - GAS(Group A streptococcus) Beta haemolytic
      - Spread by direct contact with oral or respiratory secretions
      - Enhanced by crowded living conditions
    - - Heart failure from valve insufficiency or stenosis
        
        thrombi in the appendages or along the wall --> embolism
        
        Atrial fibrillation secondary to atrial dilatation
        
        .
        
        pulmonary hypertension--> right ventricular hypertrophy.
        
        Infective endocarditis on deformed valves
    - - Echocardiogram : severe mitral stenosis, thickened mitral valve leaflets and dilated left atrium
        xray- straightening of upper left heart border, enlarged pulmonary artery
        diagnosed w CRHD
        
        management
        
        Access to investigation and surgery services (for people with moderate or severe disease).
        
        Adequate monitoring of anticoagulation therapy (for people with atrial fibrillation and/or artificial heart valves)
        
        Ongoing disease education and self-management support
        
        Regular secondary prevention treatment to prevent recurrent ARF
        
        \Ongoing care including regular medical review, heart monitoring and dental care
        
        improvement to environment, economic, social and behavioural conditions
        
        antibiotic - penicillin
        
        narrowing of mitral valve opening that blocks blood flow from left atrium to left ventricle
        
        COMMON AFFECTED VALVES-1)solitary mitral involvement
        2)combined aortic & mitral valve
        3)tricuspid valve
        4)pulmonary valves
        
        DEFINITION-describes a group of short-term (acute) and long-term (chronic) heart disorders that can occur as a result of rheumatic fever. One common results of rheumatic fever is heart valve damage. This damage to the heart valves may lead to a valve disorder
      - Loud P2
      - Mid diastolic murmur
        
        Bibasal crepitation
        
        Impaired flow during ventricular filling/
        Caused by turbulent blood flow
        
        Loss of stability of peripheral airway
        -rapid air entry
      - Loud S1
        
        Mitral or tricuspid valve cusps
        remains wide open at the end of diastole
        and shuts forcefully with onset of systole
      - High pulmonary pressure
    - - rheumatic fever
      - calcium deposits
      - congenital defects
      - chronic - valvulopathy , valve replacement , percutaneous balloon valvuloplasty
    - - Major criteria
        
        Carditis
        
        Migratory large joint polyarthritis
        
        Erythema marginatum
        
        Sydenham's chorea
        
        Subcutaneous nodule
      - Minor criteria
        
        Fever
        
        Arthralgia
        
        Leucocytosis
        
        Raised ESR/CRP
        
        Prolonged PR interval on ECG
    - - Plus
        
        2 or more Major criteria
        
        1 Major & 2 or more Minor criteria
      - Positive for Rheumatic Fever
  - - - asthma, anxiety,pneumonia,blockage of airways, allergic, anaemia, blood loss, carbon monoxide, heart failure, hypotension, collapsed lung, hiatal hernia
    - - Emotional response, hypo/hyperthyroidism,exercise,abnormal heart rhythm,• Hormone changes associated with menstruation, pregnancy or menopause,• Fever