CVS Pathology Lecture 6: Rheumatic Fever PDF

Pathology - Cardiovascular system – Lecture 6 Rheumatic fever Department of Nursing, Faculty of Allied Health Sciences 1  Rheumatic fever Immunologically mediated multisystem inflammatory disease Secondary to...

Pathology - Cardiovascular system – Lecture 6 Rheumatic fever Department of Nursing, Faculty of Allied Health Sciences 1  Rheumatic fever Immunologically mediated multisystem inflammatory disease Secondary to group A beta hemolytic streptococci infection Involve heart, joints, skin and brain Rheumatic heart disease remains the most common form of acquired heart disease in all age-groups More common in developing countries than developed world Department of Nursing, Faculty of Allied Health Sciences 2 Classification of Countries as Having an Endemic or Nonendemic Pattern of Rheumatic Heart Disease Department of Nursing, Faculty of Allied Health Sciences 3  Pathogenesis Antibodies directed against group A streptococcal molecules cross- react with host myocardial antigens Only 3% of infected patients develop Rheumatic fever Usually 2-3 weeks after the GAS infection Department of Nursing, Faculty of Allied Health Sciences 4 Salient features of acute rheumatic carditis The pericardium may exhibit an exudate The myocardial involvement—myocarditis Valve involvement results in necrosis and fibrin deposition along the lines of closure. Department of Nursing, Faculty of Allied Health Sciences 5 Clinical features of RF Pancarditis (50%) Sydenham’s chorea (10%) Endocarditis- murmur 2-6 months after streptococcal Myocarditis- heart failure and death infection Pericarditis- pericardial rub, Involuntary movements tamponade Polyarthritis (80%) Erythema marginatum (