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Rheumatic heart disease (Diagnosis (Electrocardiogram (ECG) to checkin…

- - - - developed from the body’s immune response to a bacteria infection with group A streptococcus (also known as Streptococcus bacteria)
        
        Group A Streptococcus infections include
        
        Sore throat
        
        Tonsillitis
        
        Skin infections
        
        Infection spread:
        
        Infection can spread by direct contact with infected wounds or skin sores.
        
        Infection can be caught when an infected person talks, coughs, sneezes small droplets contain infectious agents in the air.
        
        The droplets in the air may be breathed in by those nearby and may also contaminate hands or objects such as drinking cup or eating utensils.
        
        Infection can also spread by eating contaminated food.
      - infections includes strep throat and sore throat.
      - Early treatment of recurrent rheumatic fever can prevent progression of rheumatic heart disease.
      - A single severe episode or multiple recurrent episodes of rheumatic fever disease causes rheumatic heart disease.
  - - - The risk of RHD is more with repeated infections of rheumatic fever in children of 5-15 years of age
      - Occurrence of RHD is rare before 3 years and after 30 years of age
    - - More common in females
        
        although it is unclear whether the difference in RHD prevalence is due to a greater susceptibility to developing autoimmune response or whether social factors such as involvement in child-raising
      - RHD often becomes apparent during pregnancy due to association with higher cardiac burden
    - - Poverty
      - Unhygienic living conditions
      - Greater household crowding due to low low social economic status
      - Limited access to medical resources
      - Family history of rheumatic fever
- - - - Increased amount of C-reactive protein
        
        found during inflammation of heart cells after bacterial infection, leukocytosis.
        
        Changes & increase in the level of erythrocyte sedimentation rate, analysed by centrifugation
        
        Change and increase prolonged duration of the time impulse wave , PR wave in electrocardiography
        
        Antibodies against steptococcus bacteria is present in the serum due to antigen exposure to B-cells
        
        B-Cells lead to activation of humoral response
- - - - Reason of occurrence:
        
        Humoral and cellular-mediated immune responses occurring 1-3 weeks after the onset of streptococcal pharyngitis.
      - Mechanism of disease occurrence
        
        Human immune system recognises molecular mimicry displaced by streptococci
        
        mainly bacterial M-proteins and myosin (a cardiac antigens)
        
        valvular endothelium
        
        Laminin recognised by Antimyosin antibody (valve basement extracellular membrane matrix proteine)
        
        T -cells infiltrate valve through endothelium, activated by the binding of anti-streptococcal carbohydrates with release of tumour necrosis factor (TNF) and interleukins
      - Affected area of the heart
        
        Mitral
        
        Aortic
        
        Tricuspid
        
        Pulmonary valves
        
        Acute condition
        
        small thrombi form along the lines of valve closure.
        
        Chronic condition
        
        Thickening and fibrosis of the valve resulting in regurgitation.
      - Pathophysiology results
        
        Rheumatic fever
        
        Carditis
        
        Pancarditis
        
        Inflammation of the myocardium,
        pericardium,
        and endocardium.