OVERVIEW
Rheumatic Fever
Rheumatic fever is a systemic hypersensitivity reactive connective tissue disease that occurs after pharyngeal group A streptococcal infection. rheumaticmyocarditis (rheumatic fever) is a disease caused by rheumatic fever that involves the connective tissues surrounding the small blood vessels of the myocardial interstitium. It presents the typical basic course of rheumatic disease. Rheumatic microsomes are seen next to the small interstitial blood vessels and are most often found in the interventricular septum, left ventricle, left atrium, and left auricle. When the disease recurs repeatedly, it can form a small scar in the interstitium of the myocardium, and the contractility of the myocardium is weakened, and in severe cases, heart failure occurs. Clinical manifestations include tachycardia, arrhythmia, cardiac enlargement disproportionate to body temperature, emerging heart murmurs, pericardial effusion and heart failure.
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Department
Cardiovascular Medicine, Infection
Clinical Symptoms
Chest tightness, vague pain in the precordial area, palpitations, weakness, nausea, dizziness, tachycardia, arrhythmia, emerging heart murmur.
Hazards
May develop into rheumatic heart disease and cause permanent damage.
Complications
Rheumatic heart disease, etc.
Tests
Blood routine, electrocardiogram, echocardiogram, X-ray film, magnetic resonance, radionuclide myocardial imaging, myocardial biopsy, bacterial culture, etc.
Diagnosis
Diagnosis can be made by the combination of history, blood test, electrocardiogram or echocardiogram, myocardial biopsy, bacterial culture, etc. There are signs of heart enlargement, arrhythmia, or heart failure, or concomitant acute infectious diseases.
Treatment principle
The main focus is to control streptococcal infection, relieve symptoms and relieve pain, and the active period should be completely rested until the symptoms completely disappear.
Curative
It can relieve the symptoms, improve the quality of life and prolong the survival period.
Dietary advice
Give easy-to-digest, nutritious diet, eat small and frequent meals, and limit salt and water intake for those with heart failure.
Causes
Etiology
Pharyngeal group A streptococcus is the causative agent of the disease.
Symptoms and Diagnosis
Typical Symptoms
Patients often complain of chest tightness, vague pain in the precordial region, palpitations, weakness, nausea, and dizziness. Tachycardia, arrhythmia, cardiac enlargement disproportionate to body temperature, emerging heart murmur, pericardial effusion and heart failure are seen.
Diagnostic basis
1. Clinical manifestations of cardiac enlargement, arrhythmia or heart failure, or concomitant acute infectious diseases. 2. Chorea or painless carditis (i.e., insidious onset or slow progression of carditis) can be the only sign of rheumatic fever. 3. Electrocardiogram, X-ray, radionuclide myocardial imaging, and bacterial culture can assist in the diagnosis. 4.
Treatment
Treatment guidelines
The main focus is to control the streptococcal infection, relieve symptoms, and relieve the pain of the disease. The active phase should be completely rested until the symptoms disappear completely.
Drug therapy
To control streptococcal infection, antibiotic treatment is used in the acute stage. Penicillin is preferred, and oral macrolide antibiotics or narrow-spectrum cephalosporins can be used when allergic or resistant to penicillin. Certain immunosuppressive agents such as glucocorticoids, cyclophosphamide, and azathioprine may be effective in treatment.
Prognosis
Depending on the size of the accumulated cardiac extent of the lesion, pharmacologic or surgical treatment may relieve symptoms and prolong survival.
Nursing care
Daily care
1. Limit physical activity and avoid strenuous exercise during the recovery period. 2. Prevent upper respiratory tract infections. 3. Avoid cold and dampness.
Dietary regimen
1. Give easy-to-digest, high-protein and vitamin diets. 2. Eat small, frequent meals and more vegetables and fruits. 3. Avoid cold, raw and irritating foods.