Medicine an Surgery notes

Apr 25th, 2015
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Rheumatic Heart DiseaseASHIONO E. M1Rheumatic Heart DiseaseInflammatory process that may affect themyocardium, pericardium and orendocardiumUsually results in distortion and scarring ofthe valves2M:F 1:1, but poorer prognosis in femalesMedian age 10yrs, 20% of cases occur in adultsDiagnosis of RHD is made after confirming antecedent RFthe modified Jones criteriaEvidence of previous GABHS pharyngitis:1.2.3.Positive throat culture or rapid streptococcal antigen test resultElevated or rising streptococcal antibody titerHistory of previous RF or RHD3Cardiac Manifestations of Acute RFPancarditis - most serious complication of RF (50%) detected by a new murmur & tachycardia out of proportionto feverAdvanced cases: dyspnea, mild-to-moderate chestdiscomfort, pleuritic chest pain, edema, cough or orthopneaEcho-Doppler evidence of mitral insufficiency in associationwith AI, may be sufficient for a diagnosis of carditis (even inthe absence of accompanying auscultatory findings)Other cardiac manifestations include CHF & pericarditis4Rheumatic Heart Disease, cont.Subjective symptomsPrior history ofrheumatic feverGeneral malaisePain may or may notbe presentObjective symptomsTemperatureMurmursDyspneapolyarthritis5..New or Changing MurmursMurmurs of acute RF due to valve insufficiencyApical pansystolic murmur

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