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Rheumatic Heart Diseases

Rheumatic Heart Diseases. Ahmad Osailan. Fast review of the heart . Valves of the heart . Function- prevent blood from flowing backwards Responds to changes in pressure Two types of valves in heart Atrioventricular valves (AV) Semi-lunar valves. What is Rheumatic Heart Disease.

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Rheumatic Heart Diseases

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  1. Rheumatic Heart Diseases Ahmad Osailan

  2. Fast review of the heart

  3. Valves of the heart • Function- prevent blood from flowing backwards • Responds to changes in pressure • Two types of valves in heart • Atrioventricular valves (AV) • Semi-lunar valves

  4. What is Rheumatic Heart Disease • is a rare form of heart disease that typically impacts children.  It is caused by having rheumatic fever, which itself is a complication from the strep throat bacteria.  • The inflammation from rheumatic fever causes the heart valves to become weaker and not push through the blood as they should, thus creating heart disease.

  5. What is Rheumatic Fever • Rheumatic fever is an inflammatory disease that is developed when the streptococcal bacteria is not treated.  • This bacteria is the cause of strep throat and fever.  While adults can get Rheumatic fever, it is typically a children’s illness, especially for children between the ages of 5 – 16

  6. Streptoccocus affects different area of the heart: • Endocardium Endocarditis • Myocardium  Myocarditis • Pericardium  Pericarditis • Resulting in: • Distortion and scaring of the valves causing stenosis or widening • Endocardium is the most affected one

  7. Symptoms of Rheumatic Heart Disease • Fever • Swollen and red joints • Murmur • Breathlessness (dyspnea) • Fatigue • Chest pain • Fainting attacks • Palpitations

  8. RHD mostly is the cause of Valve Heart disease

  9. Types of Valve Diseases • Mitral Stenosis • Mitral Regurgitation • Mitral Valve Prolapse • Aortic Stenosis • Aortic regurgitation • Tricuspid valve is affected infrequently • Tricuspid stenosis – causes Rt HF • Tricuspid regurgitation –causes venous overload

  10. Mitral Stenosis • Is a thickening of Valve by fibrosis or calcification. • What happen to the valve? • Valve leaflets fuse and become stiff and the cordaetendineae contract

  11. What happen after mitral stenosis • These narrows the opening and prevents normal blood flow from the LA to the LV • LA pressure increases left atrium dilates, Pulmonary Artery Pressure increasesthe RV hypertrophies. • Pulmonary congestion and right sided heart failure occurs.

  12. Objective findings of mitral stenosis • Pulse may be normal to A-Fib • Apical diastolic murmur is heard

  13. Mitral Regurgitation • caused by papillary muscle rupture form congenital, infective endocarditis. • Abnormality prevents the valve from closing • Blood flows back into the right atrium during systole • During diastole the regurg output flows into the LV with the normal blood flow and increases the volume into the LV

  14. Aortic Stenosis • Valve becomes stiff and fibrotic, impeding blood flow with LV contraction • Results in LV hypertrophy, increased O2 demands, and pulmonary congestion • Caused by – rheumatic fever, congenital, arthrosclerosis • Complications – right sided heart failure, pulmonary edema, and A-fib.

  15. Diagnosis • History and physical findings • EKG • Chest x-ray • Cardiac cath • Echocardiogram

  16. Surgical Management of Valve Disease • Most of the valve disease of the heart are treated surgically by • VALVE REPLACEMENT • There are 2 types of Valve Replacement • 1- Mechanical Valve • 2- Tissue Valve

  17. Difference between Mechanical V and Tissue V • Artificial Valves tissue Valves • Life expectancy (20) 10-15 years, Limited durability • High Susceptibility of Blood clot Less likely for clotting • Patient on Antiplatelet patient is on immune supressant

  18. Rehabilitation for Post valve replacement • Will be discussed in Cardiac rehabilitation lecture.

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