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RHEUMATIC HEART DISEASE - Coggle Diagram
RHEUMATIC HEART DISEASE
Definition
chronic condition resulting from rheumatic fever (occurs after an untreated or inadequately treated streptococcal throat infection. RHD involves permanent damage to the heart valves due to inflammation and scarring caused by the autoimmune response triggered by rheumatic fever.
Clinical presentation
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in some cases, cough with pink frothy sputum
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Exertional dyspnea, orthopnea, PND
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Pathophysiology
Molecular Mimicry: These antibodies cross-react with human tissues, particularly in the heart, due to structural similarities between streptococcal antigens and heart proteins.
Inflammation: This immune response causes inflammation in the heart, joints, skin, and nervous system, leading to rheumatic fever.
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Valve Damage: Recurrent or severe inflammation damages heart valves (commonly the mitral and aortic valves), leading to: Fibrosis, Valvular stenosis, Valvular regurgitation
Progression to Chronic RHD: Over time, cumulative damage impairs valve function, potentially causing heart failure, arrhythmias, or thromboembolism.
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Treatment
Medical
Empirical
Native Valve Endocarditis: Vancomycin + beta-lactam (e.g., ceftriaxone or cefepime)
Prosthetic Valve Endocarditis (≤ 1 year after placement): Vancomycin + beta-lactam + gentamicin + rifampin.
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Examination
murmurs (mitral stenosis or regurgitation, aortic stenosis or regurgitation)
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in some cases, pulmonary crackles
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in some cases, cardiomegaly
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