rheumatic heart disease
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Epidemiology
- affects mostly children 5-15 years of age,
- may also occur in adults, especially in crowded conditions
Pathology
- carditis
- valvular heart disease
- mitral valve most commonly involved
- mitral valve stenosis
- thickening & fusion of mitral valve leaflets[3]
- mitral regurgitation
- mitral valve stenosis
- mitral valve most commonly involved
Laboratory
- see rheumatic fever
Diagnostic procedures
Management
- also see rheumatic fever
- prednisone 40-60 mg QD
- useful for controlling pericarditis & CHF of acute rheumatic fever
- no effect on residual heart disease
- prophylaxis (documented rheumatic fever with vavlular sequellae)
- long-term prophylactic penicillin for at least 10 years after last episode or until at least age 40 (whichever is longer)[3]
- benzathine penicillin G 1.2 million units IM every 4 weeks
- erythromycin 100-250 mg PO BID
- sulfadiazine 0.5-1 g PO QD
- erythromycin 100-250 mg PO BID
- prophylaxis for bacterial endocarditis prior to surgical procedures
- long-term prophylactic penicillin for at least 10 years after last episode or until at least age 40 (whichever is longer)[3]
More general terms
References
- ↑ World Heart Fedaration: Rheumatic Heart Disease http://www.world-heart-federation.org/press/fact-sheets/rheumatic-heart-disease/
- ↑ Chin TK and Berger S eMedicine: Pediatric Rheumatic Heart Disease http://emedicine.medscape.com/article/891897-overview
- ↑ 3.0 3.1 3.2 Otto CM et al 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease. A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021;143:e00 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33332150 https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000923