I. How is rheumatic heart disease caused?
Rheumatic heart valve disease, also known as rheumatic heart disease, or rheumatic heart disease for short, is a heart disease mainly caused by valve lesions left over from acute rheumatic myocarditis. After repeated inflammation of the original smooth, thin, soft and elastic valves, the valves become thickened, adherent, deformed and the tendons shorten and thicken, resulting in valve stenosis or incomplete closure. Mitral valve lesions alone are the most common, followed by mitral valve combined with aortic valve lesions, mainly manifesting as heart valve stenosis or incomplete closure.
Rheumatic heart disease is more common in young people, with more women than men, and 2/3 of patients have had classic rheumatic fever. Rheumatic fever is associated with hemolytic streptococcal infection, an autoimmune disease that results in a metabolic reaction to infection by group B A hemolytic streptococci, and occurs mostly in the winter and spring. In addition, viral infections, genetic factors and immune function may also be related to the development of rheumatic fever.
Second, the clinical manifestations of rheumatic heart disease
Rheumatic heart disease has no obvious symptoms in the early stage, but later on, a series of symptoms of cardiac dysfunction and even death due to heart failure appear due to impaired cardiac function. The symptoms are different for different clinical types.
1, mitral stenosis with symptoms of left heart failure: exertional dyspnea, paroxysmal nocturnal dyspnea, telescopic breathing, cough, coughing up blood, coughing up pink foamy sputum, etc.
2.Symptoms of mitral valve insufficiency: palpitations, fatigue, weakness, exertional dyspnea, etc.
3.Symptoms of aortic stenosis: dizziness, syncope, angina pectoris or arrhythmia, and even sudden death.
4.Symptoms of aortic valve insufficiency: palpitation, chest tightness, chest pain, etc. Patients feel a sense of vibration in the head, and the pulsation of carotid and dorsalis pedis arteries is more obvious.
Third, the treatment of rheumatic heart disease
1.Medication: actively treat rheumatic fever, maintain and improve the compensatory function of the heart.
2.Surgical treatment: heart valve separation, artificial heart valve replacement.
3.Treatment of complications.
4.Prevent colds and rheumatic activities.
4.What should be paid attention to in daily life for patients with wind heart disease?
1, psychological adjustment Wind heart disease mostly occurs in children and young people, into middle age, the symptoms gradually developed, the patient is faced with the disease, loss of labor and young women facing childbirth problems, most patients are depressed, heavy concern, anxiety, this state of mind is not conducive to control the development of the disease. Patients with wind heart disease should face the disease with a positive and optimistic attitude, understand the disease, and believe that as long as they cooperate with the doctor’s treatment, they can improve heart function, promote disease recovery, and prevent complications from occurring.
2.Rational diet Eat a light, easy-to-digest, high-calorie, high-protein, high-vitamin diet, such as fish, meat, eggs, milk, etc., to promote the body’s recovery and increase the patient’s resistance. Prohibit spicy and stimulating food, avoid drinking strong tea or coffee, eat less food containing high cholesterol, such as animal offal, fat, etc., eat more soy products, and eat more watermelon in summer, which not only can supplement vitamin C, but also has a diuretic effect. Take more vegetables, fruits and fiber-rich foods to prevent constipation. Control water intake and limit salt intake to prevent edema from worsening. Generally speaking, the daily salt intake of patients with wind heart disease is below 5 grams, and avoid salt-cured products. Eat small and frequent meals, and avoid overeating.
3.Adequate rest, appropriate activities Ensure sufficient sleep, 8-10 hours is appropriate. Rheumatic activities should be bed rest to reduce the load on the heart, but can turn over in bed, eating, watching TV, listening to the radio, reading books and newspapers, etc.. After the symptoms are controlled, it is appropriate to move the lower limbs, massage and soak the feet in warm water or get out of bed to prevent the formation of deep vein thrombosis in the lower limbs, the extent of which is limited to not having chest tightness, shortness of breath, palpitations or relieved after a few minutes of rest. Patients with atrial fibrillation should pay attention to prevent breath-holding and sudden force and violent coughing to reduce thrombus dislodgement and prevent embolism.
V. How to prevent wind heart disease?
Since the direct cause of rheumatic heart disease is rheumatic fever, it is necessary to effectively prevent the occurrence and development of rheumatic fever. Its main preventive measures are.
1, improve the standard of living, improve the living environment, avoid cold, humidity, fatigue, hunger; improve the work, production environment; reduce labor intensity; strengthen physical exercise, enhance the body’s resistance; diet on time, strengthen nutrition, enhance the body’s nutrition, enhance the strength of resistance to disease;
2, actively treat colds, tonsillitis, pharyngitis, otitis media, scarlet fever, upper respiratory tract infections, etc. Avoid strong physical labor, so as not to aggravate the disease. Tonsillectomy can be done if necessary.
3, repeated episodes of rheumatic fever activity can be injected with long-acting penicillin star benzathine to prevent streptococcal infection. Penicillin allergy or unwilling to inject penicillin can be oral erythromycin, etc. Prophylaxis should be given to pediatric patients for a minimum of 18 years and to adult patients for a minimum of 5 years. For patients with high susceptibility factors such as cold and damp, repeated recurrence of rheumatic fever and rheumatic valve disease, the duration of prophylaxis should be extended as long as possible, even for life.