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Rheumatic heart disease pathophysiology

Rheumatic heart disease (RHD) is a chronic and progressive form of damage to the heart valves resulting in dysfunction of the heart. It is a complication of an autoimmune disorder called acute rheumatic fever (ARF), which is in turn precipitated by group A streptococcal infections of the throat.Feb 27, 2019

What happens to the heart in Rheumatic heart disease?

Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.

What valves are affected by Rheumatic heart disease?

Although rheumatic fever can affect any heart valve, it most commonly affects the la válvula mitral which lies between the two chambers of the left side of the heart. The damage can cause valve stenosis, valve regurgitation and/or damage to the heart muscle.

Which murmur is heard in Rheumatic heart disease?

The murmur is described as a mid-diastolic murmur heard at the mitral listening post with the bell of the stethoscope with the patient in the left lateral decubitus position at end expiration. As the rheumatic valvulitis resolves, the murmur disappears.

What is the most common serious complication of Rheumatic heart disease?

The major cause of death and disability from RHD is de insuficiencia cardiaca. Over time, scarred and damaged heart valves make it impossible for the heart to pump blood effectively. Without a well-functioning heart, fluid builds up in the lungs and body, causing symptoms like breathlessness, swelling and fatigue.

What causes hypertensive heart disease?

Chronic high blood pressure (higher than 120/80 mmHg) causes hypertensive heart disease. As people get older and continue to have high blood pressure, their risk of heart disease increases. Heart failure occurs most often in people older than 65.

What is radiation heart disease?

Radiation can injure the pericardium (the tissue covering the heart), myocardium (the heart muscle itself), the heart valves, coronary arteries and the heart’s electrical system. Some of the problems that may develop are: Pericarditis (inflammation of the tissue surrounding the heart)

Why mitral valve is most affected in RHD?

The mitral valve is the most commonly affected in RHD. Approximately 90% of people with RHD have mitral valve involvement. Mitral regurgitation the mitral valve does not close properly, causing backflow of blood from the left atrium to the left ventricle.

What are the complications of rheumatic heart disease?

Las complicaciones incluyen de insuficiencia cardiaca, which means the heart is unable to pump blood effectively. The strain causes the heart to enlarge. Other complications of RHD include infection of damaged heart valves (infective endocarditis) and stroke due to clots forming in the enlarged heart or on damaged valves.

Which valve is most commonly affected by infective endocarditis?

Infective endocarditis develops most commonly on the la válvula mitral, closely followed in descending order of frequency by the aortic valve, the combined mitral and aortic valve, the tricuspid valve, and, rarely, the pulmonic valve. Mechanical prosthetic and bioprosthetic valves exhibit equal rates of infection.

What happens to mitral valve in rheumatic heart disease?

Fiebre reumática.

A complication of strep throat, rheumatic fever can damage the mitral valve. Rheumatic fever is the most common cause of mitral valve stenosis. It can damage the mitral valve by causing the flaps to thicken or fuse. Signs and symptoms of mitral valve stenosis might not show up for years.

What is the prognosis of rheumatic heart disease?

Those who had mild RHD at diagnosis had the most favorable prognosis, with over 60% remaining mild after 10 years, and 10% being inactive by the end of the 14?year study period. Nonetheless, nearly 30% of this group demonstrated disease progression (18.3% moderate, 11.4% severe, half of whom had surgery) by 10 years.

¿Cuáles son los efectos secundarios a largo plazo de la fiebre reumática?

Serious Complications Include Long-term Heart Damage

If rheumatic fever is not treated promptly, long-term heart damage (called rheumatic heart disease) may occur. Rheumatic heart disease weakens the valves between the chambers of the heart. Severe rheumatic heart disease can require heart surgery and result in death.

Who is most affected by rheumatic heart disease?

Rheumatic heart disease is the most commonly acquired heart disease in people under age 25, and mostly affects children and adolescents in low- and middle-income countries.

What type of heart failure is caused by hypertension?

Hypertensive heart disease can lead to either diastolic heart failure, systolic failure, or a combination of the two. Such patients are at a higher risk for developing acute complications such as decompensated heart failure, acute coronary syndrome, or sudden cardiac death.

What is the difference between hypertension and hypertensive heart disease?

Hypertensive heart disease refers to heart problems that occur because of high blood pressure that is present over a long time. Hypertension is a disorder characterized by consistently high blood pressure.

What is a risk factor for heart disease?

Leading risk factors for heart disease and stroke are presión arterial alta, colesterol alto de lipoproteínas de baja densidad (LDL), diabetes, tabaquismo y exposición al humo de segunda mano, obesidad, dieta poco saludable e inactividad física.

What are the symptoms of radiation heart disease?

RIHD comprises a spectrum of heart disease including cardiomyopathy, pericarditis, coronary artery disease, valvular heart disease and conduction system abnormalities. There are numerous clinical manifestations of RIHD, such as chest pain, palpitation, and dyspnea, even without obvious symptoms.

Can breast radiation affect the heart?

While radiotherapy plays a crucial role in treating breast cancer, it can cause incidental damage to the heart and lungs, that may in turn increase the risk of heart disease and lung cancer.

Does radiation cause heart failure?

Radiation therapy can cause heart attack, heart failure, and arrhythmias. Traditional and novel chemotherapy agents can damage the heart or peripheral blood vessels, or cause problems with clotting or blood lipids.

Can rheumatic heart disease cause mitral valve prolapse?

Sin embargo, more recent surgical pathologic data also have demonstrated a high incidence of mitral valve prolapse in cases of rheumatic heart disease, which suggests that rheumatic fever may be a cause of mitral valve prolapse.

Why does rheumatic fever cause mitral stenosis?

When your mitral valve isn’t functioning correctly, blood and pressure build up, the left atrium enlarges, and fluid enters the lungs. The most common cause of mitral stenosis is rheumatic fever a complication of strep throat. This infection can scar the mitral valve, causing it to narrow.

What is rheumatic disease?

Rheumatic diseases are autoimmune and inflammatory diseases that cause your immune system to attack your joints, muscles, bones and organs. Rheumatic diseases are often grouped under the term arthritis which is used to describe over 100 diseases and conditions.

How does VSD cause endocarditis?

Patients with congenital heart defects are especially prone to endocarditis. Blood moves at high velocity across defects such as VSD’s, stenotic or leaky valves, and PDA’s. This high velocity flow facilitates the sticking of the blood’s clotting elements to these defects.

What type of murmur is associated with endocarditis?

Endocarditis infecciosa aguda

El tipo más común es un soplo de regurgitación aórtica. Because of the suddenness of onset, the left ventricle does not have a chance to dilate. In this situation, the classic finding of increased pulse pressure in significant valvular insufficiency is absent.

¿Cuál es el agente causal más común de la endocarditis bacteriana?

Dos tipos de bacterias causan la mayoría de los casos de endocarditis bacteriana. Estos son estafilococos (estafilococos) y estreptococos (estreptococos). Puede tener un mayor riesgo de endocarditis bacteriana si tiene ciertos defectos en las válvulas cardíacas.

¿Qué causa los problemas de la válvula mitral?

One of the main causes of mitral valve stenosis is cardiopatía reumática. This is where an infection causes the heart to become inflamed. Over time, it can cause the flaps of the mitral valve to become hard and thick.

What causes mitral facies?

Mitral facies refers to the abnormal flushing of the cheeks that occurs from cutaneous vasodilation in the setting of severe mitral valve stenosis (usually rheumatic in origin) causing a low cardiac output state.

How does strep throat lead to congestive heart failure?

When your body senses the strep infection, it sends antibodies to fight it. Sometimes, these antibodies attack the tissues of your joints or heart instead. If the antibodies attack your heart, they can cause your heart valves to swell, which can lead to scarring of the valve doors (called leaflets or cusps).

Is rheumatic heart disease serious?

Rheumatic heart disease is heart valve damage due to rheumatic fever. The fever is your body’s inflammatory response to a bacterial infection. Children in poor countries without access to antibiotics are at the highest risk. The condition can lead to serious health problems, including heart failure.

Is rheumatic heart disease hereditary?

Although rheumatic heart disease is caused by an infection, research has shown that some families are more likely to develop the condition than others a genetic component to developing the disease.

Can rheumatic fever be cured?

La fiebre reumática no tiene cura, pero los tratamientos pueden controlar la afección. Obtener un diagnóstico preciso poco después de que aparezcan los síntomas puede evitar que la enfermedad cause un daño permanente. Las complicaciones graves son raras. Cuando ocurren, pueden afectar el corazón, las articulaciones, el sistema nervioso o la piel.

Can rheumatic fever come back in adulthood?

Rheumatic fever is a very rare complication that can develop after a bacterial throat infection. It can cause painful joints and heart problems. Most people make a full recovery, but it can come back.

Can rheumatic heart disease be treated?

There is no cure for rheumatic heart disease and the damage to the heart valves are permanent. Patients with severe rheumatic heart disease will often require surgery to replace or repair the damages valve or valves.

Can I give blood if I have had rheumatic fever?

Rheumatic fever can cause damage to the heart and this could make it unsafe to give blood.

What are the mitral valve disorders?

Mitral valve disease is a problem with the valve located between the left heart chambers (left atrium and left ventricle). Mitral valve disease includes: Regurgitación de la válvula mitral.. The mitral valve flaps (leaflets) may not close tightly, causing blood to leak backward.

What causes infection around the heart?

A heart infection can happen when microbes or other irritants invade your heart. The infections are most commonly caused by bacteria, viruses, and less commonly, by fungi. A heart infection can damage or inflame your heart.

Fuente: RealOnomics.net

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Tommy E. Junkins

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