Rheumatic Heart Disease

                                 Rheumatic Heart Disease

•    Rheumatic Heart Disease is usually affect the children and it is still the most common cause of acquired heart disease in childhood and adolescence.

Incidence :-

• R.H.D. is usually affects 5-15 years child.
• 1-2 case / lakh in developed countries.
• 100 case/ lakh in developing countries.
• 3% people affect after the beta-hemolytic strptococci infection.

Pathophysiology :-

• due to etiological factor
• persistent infection of through streptococci.   
• Antigen of beta-hemolytic streptococci react.
• cross react with myosin and sarcolema membrane.
• bind the receptor on the heart.
• Inflammatory response in the cardiac muscle.
• severe & permanent heart damage.

Clinical Manifestation  :-

• carditis 
• cardiomegaly
• murmur
• pericarditis
• chest pain
• AV deffect
• Arterial fibrillation
• fever
• dysrhythmia
• Pnemonia signs
• Involuntry movement or speach after 3 month of disease.

Diagnostic Evaluation :-

• blood test
• throat swab
• chest x-ray
• ECG
• 2D echo

Management :-

Medical management :-

• Anti-biotics
• Aspirine
• Corticosteroid
• Bed rest & Supporting therapy

Nursing Management :-

• Chronic pain related to inflammatory response.
• Activity intolerance related to reduce cardiac pressure and inforced bed-rest.
• Imbalanced nutrition less the body requirement related to sever inflammation & fatigue.
• Risk for ineffective therapeutic resimen management related to need for life long threapy.