Rheumatic Heart Disease
- Rheumatic fever is an inflammatory disorder that can result from strep throat infection. It typically occurs in children aged 5-15 years. Signs and symptoms include a sore throat, fever, headache, fatigue, joint pain and swelling, and a rash.
- Rheumatic fever can damage the heart, causing valve problems which can lead to heart failure or heart disease later in life. The inflammation can also affect the brain and cause abnormal movements, known as Sydenham chorea.
What is chorea?
Chorea is characterized by sudden, jerky, involuntary movements of the face, arms, and legs. Chorea can also cause muscle weakness, slurred speech, and difficulty with balance and coordination. It is believed to be caused by inflammation in certain areas of the brain, although the exact mechanisms of this condition are not fully understood.
- Pay attention to symptoms: Non-tender subcutaneous nodules, but tender joints due to polyarthritis. If it causes damage to heart (Carditis), think heart murmur and heart enlargement. Mainly affects mitral valve.
- Erythema Marginatum: red rash mainly over trunck that spread peripherally (margin).
- Laboratory finding : , ↑ Antistreptolysin O (ASO) titer, ↑ ESR (erythrocyte sedimentation rate) and ↑ CRP (C reactive protein). ESR and CRP are indicators of inflammation
Prevention
Treat and identify all streptococcal throat infections such as scarlet fever.
Treatment
- Antibiotics such as penicillin, amoxicillin or erythromycin
- Anti-inflammatory meds (Ibuprofen & Aspirin)Â
- Corticosteroids such as prednisone
- Bed rest during the acute stage of the illnes. These children have carditis.
- Regular monitoring of heart function and valve damage with echocardiogram
- Antibiotic prophylaxis for dental work, infections and invasive procedures
- Seizure precautions if child has chorea (Involuntary, jerky movements).
- EKG: Monitor for Prolonged PR Interval
The nurse admits a child diagnosed with rheumatic fever. Which of the following clinical findings should the nurse anticipate.
Please select 5 correct answers
Correct!
Wrong!
The nurse is admitting a child with rheumatic fever. Which of the following is a pertinent question to ask the parents?
Correct!
Wrong!
Which laboratory finding does the nurse anticipate in a child with rheumatic fever?
Correct!
Wrong!