When minor manifestations alone are present, the exclusion of other more likely causes of the clinical presentation is recommended before a diagnosis of an ARF recurrence is made (Class I, Level of Evidence C). [acc.org]

Low-grade carditis may present too late for diagnosis of the RF. [patient.info]

INVESTIGATIONS • ECG: Sinus tachycardia Sinus bradycardia First-degree atrioventricular (AV) block (prolongation of the PR interval) ST segment elevation may be present and is marked most in lead II, III, aVF, and V4 -V6 28 29. [slideshare.net]

Susan Swedo, of the NIMH, presents at University of Wisconsin School of Medicine Grand Rounds on pediatric autoimmune neuropsychiatric disorder associated with strep infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS). ... [moleculeralabs.com]

• Pain

  It can cause painful joints and heart problems. Most people make a full recovery, but it can come back. [nhs.uk]

  Common symptoms of rheumatic fever include: small, painless nodules under the skin chest pain rapid fluttering or pounding chest palpitations lethargy or fatigue nosebleeds stomach pain painful or sore joints in the wrists, elbows, knees, and ankles pain [healthline.com]

  Arthritis, or pain and swelling in the joints, affects 75 percent of patients. [medicalnewstoday.com]

  “The nurses have told me he has a high pain threshold, but he can’t wait until the day they create a tablet. [health.qld.gov.au]

  Rheumatic fever signs and symptoms — which result from inflammation in the heart, joints, skin or central nervous system — can include: Fever Painful and tender joints — most often in the knees, ankles, elbows and wrists Pain in one joint that migrates [mayoclinic.org]

• Inflammation

  The inflammation may also lead to headache, sweating, vomiting, and weight loss. Treatment Treatment aims to destroy the bacteria, relieve symptoms, control inflammation, and prevent recurrences of RF. [medicalnewstoday.com]

  The inflammation typically occurs following throat infection ("strep throat"), though fortunately only occurs in less than 3% the population. The inflammation in rheumatic fever may involve the brain ("nervous system"), joints, skin, and heart. [childrensheartinstitute.org]

  Complications Inflammation caused by rheumatic fever can last a few weeks to several months. In some cases, the inflammation causes long-term complications. Rheumatic heart disease is permanent damage to the heart caused by rheumatic fever. [mayoclinic.org]

  A child must show evidence of a prior strep infection through throat culture or blood work, as well as labs that show inflammation in the body. [chop.edu]

  The inflammation "moves" from one joint to another over several days. [chw.org]

• Crying

  Vitus' dance) — most often in the hands, feet and face Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea When to see a doctor Have your child see a doctor for signs or symptoms of strep throat. [mayoclinic.org]

  […] in one joint that moves to another joint red, hot, swollen joints shortness of breath fever sweating vomiting a flat, slightly raised, ragged rash jerky, uncontrollable movements of the hands, feet, and face a decrease in attention span outbursts of crying [healthline.com]

  Inflammation of the nerves can lead to symptoms of Sydenham's chorea, including: chorea, the uncontrollable jerking of knees, elbows, wrists, and ankles inappropriate crying or laughing irritability and moodiness difficulty controlling fine hand movements [medicalnewstoday.com]

  […] rheumatic fever can develop involuntary and uncontrolled jerking and twitching of the body, mostly hands and feet, difficulty in performing task requiring fine hand movements such as writing, problem with balance, unusual emotional outbursts, such as crying [nhp.gov.in]

  Onset of chorea is typically insidious and may be preceded by inappropriate laughing or crying. Chorea consists of rapid and irregular jerking movements that may begin in the hands but often becomes generalized, involving the feet and face. [merckmanuals.com]

• Malaise

  Critical Essential Core Tested Community Questions (3) (M2.CV.36) A 15-year-old girl presents with four days of malaise, painful joints, nodular swelling over her elbows, low-grade fever, and a rash on her chest and left shoulder. [medbullets.com]

  Symptoms Symptoms of ARF include: fever malaise (feeling of being unwell) painful and/or swollen joints (one or many joints) – usually affecting the elbows, wrists, hips, knees and ankles chest pain, difficulty breathing, or a rapid heartbeat and heart [sahealth.sa.gov.au]

  Case 1 A twelve year-old girl presented with a two week history of myalgia and general malaise. [omicsonline.org]

  Fever (≥ 38.5° C) and other systemic manifestations such as anorexia and malaise can be prominent but are not specific. ARF can occasionally manifest as FUO until a more identifiable sign develops. [merckmanuals.com]

  After an incubation period of 2-4 days, the invading organisms elicit an acute inflammatory response with 3-5 days of sore throat, fever, malaise, headache, and an elevated leukocyte count. [emedicine.medscape.com]

• High Fever

  Less common are nosebleeds, abdominal pain, bumps and lumps, or nodules, under the skin, and a high fever over 102 degrees Fahrenheit. The inflammation may also lead to headache, sweating, vomiting, and weight loss. [medicalnewstoday.com]

  In the first episode of acute rheumatic fever, carditis occurs in about 50 to 70%. Patients may have high fever, chest pain, or both; tachycardia is common, especially during sleep. [merckmanuals.com]

• Chest Pain

  The symptoms that you might face due to rheumatic heart disease are: Chest pain. Heart palpitations. Shortness of breath. Swollen ankles, wrists, and stomach. Excessive fatigue. Thumping sensation in chest. [medanta.org]

  Symptoms Your child may have signs and symptoms that affect the heart, including: Trouble breathing Chest pain Swelling (edema) of the feet and ankles Heart murmur Your child may also have other signs and symptoms of rheumatic fever. [stlouischildrens.org]

  Symptoms of moderate to severe RHD can include chest pain, breathlessness with physical activity or when lying down, weakness and tiredness, and swelling of the legs and face. [rhdaustralia.org.au]

• Palpitations

  Heart palpitations. Shortness of breath. Swollen ankles, wrists, and stomach. Excessive fatigue. Thumping sensation in chest. Causes The prime cause of Rheumatic fever is Group A Streptococcus. [medanta.org]

  Symptoms Symptoms of heart valve problems, which are often the result of rheumatic heart disease, can include: chest pain, excessive fatigue, heart palpitations (when the heart flutters or misses beats), a thumping sensation in the chest, shortness of [heartandstroke.ca]

  People with RHD may have no symptoms for years or only mild symptoms (such as shortness of breath with exercise or on lying down, tiredness, weakness or palpitations) until complications develop. [sahealth.sa.gov.au]

  Common symptoms of rheumatic fever include: small, painless nodules under the skin chest pain rapid fluttering or pounding chest palpitations lethargy or fatigue nosebleeds stomach pain painful or sore joints in the wrists, elbows, knees, and ankles pain [healthline.com]

  Inflammation of the heart can lead to chest pain, palpitations, a sensation that the heart is fluttering or pounding hard, panting, and shortness of breath, and fatigue. [medicalnewstoday.com]

• Hypertension

  It also includes key risk factors like: hypertension (high blood pressure) high blood cholesterol. CVD is a substantial problem for the Aboriginal and Torres Strait Islander community [32052]. [healthinfonet.ecu.edu.au]

  - Right Ventricular Hypertrophy : Cor pulmonale may develop as a result of a reactive pulmonary hypertension ; - Lesions of the central nervous system : Sydenham's chorea - There is disordered and involuntary movements of the trunk and extremities. [histopathology-india.net]

  Hypertensive Heart Disease. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/162449-overview through http://emedicine.medscape.com. Accessed April 2011. Nghiem, H. (2011 February 18). [labtestsonline.it]

  Once significant limiting symptoms occur, there is a 0-15% 10-year survival rate without treatment. [11] Severe pulmonary hypertension is a bad prognostic sign. [emedicine.medscape.com]

  Bosentan for patients with echocardiographic evidence of pulmonary hypertension due to long-standing rheumatic mitral stenosis. Hellenic Journal of Cardiology. 2015; 56 (1):36–43. [ PubMed : 25701970 ] Voss L. M., Wilson N. J., Neutze J. [ncbi.nlm.nih.gov]

• Sweating

  […] rapid fluttering or pounding chest palpitations lethargy or fatigue nosebleeds stomach pain painful or sore joints in the wrists, elbows, knees, and ankles pain in one joint that moves to another joint red, hot, swollen joints shortness of breath fever sweating [healthline.com]

  The inflammation may also lead to headache, sweating, vomiting, and weight loss. Treatment Treatment aims to destroy the bacteria, relieve symptoms, control inflammation, and prevent recurrences of RF. [medicalnewstoday.com]

• Arthritis

  Arthritides, Acute Rheumatic, Arthritis, Acute Rheumatic, Arthritis, Rheumatic, Acute, Articular Rheumatism, Acute, Articular Rheumatisms, Acute, Fevers, Rheumatic, Polyarthritis Rheumatica, Polyarthritis Rheumaticas, Rheumatic Arthritides, Acute, Rheumatic [fpnotebook.com]

  The constellation of signs and symptoms required to make the diagnosis include arthritis, carditis, subcutaneous nodules, rash, and Sydenham chorea. - arthritis: the arthritis is typically symmetrical and involves large joints such as the knees, ankles [childrensheartinstitute.org]

  […] disease, drug reactions, and gonococcal arthritis. [merckmanuals.com]

  Differential diagnosis [ 13 ] Arthritis - consider: Rheumatoid arthritis (including Still's disease in children). Henoch-Schönlein purpura. Reactive arthritis. Erythema nodosum. Heart disease - consider: Cardiomyopathy. Kawasaki disease. [patient.info]

  ARTHRITIS • Most common manifestation. (70%) • Large joints (knee, elbow, ankle, wrist) • Poly arthritis- succession or simultaneous • Migratory in nature • Swelling, heat, redness, severe pain, tenderness ,limitation of movement • Responds drammatically [slideshare.net]

• Headache

  The inflammation may also lead to headache, sweating, vomiting, and weight loss. Treatment Treatment aims to destroy the bacteria, relieve symptoms, control inflammation, and prevent recurrences of RF. [medicalnewstoday.com]

  […] evaluation: tender and swollen lymph nodes red rash difficulty swallowing thick, bloody discharge from nose temperature of 101°F (38.3°C) or above tonsils that are red and swollen tonsils with white patches or pus small, red spots on the roof of the mouth headache [healthline.com]

  Viral Pharyngitis: Clinical and Epidemiologic Findings Features suggestive of GAS infection Beefy, swollen, red uvula Fever Headache History of exposure to GAS Nausea, vomiting, and abdominal pain Pain with swallowing Patient 5 to 15 years of age Presentation [aafp.org]

  Salicylate toxicity is the limiting factor to aspirin therapy and is manifested by tinnitus, headache, or hyperpnea; it may not appear until after 1 wk of therapy. Salicylate levels are measured only to manage toxicity. [merckmanuals.com]

  After an incubation period of 2-4 days, the invading organisms elicit an acute inflammatory response with 3-5 days of sore throat, fever, malaise, headache, and an elevated leukocyte count. [emedicine.medscape.com]

“Our program is improving long-term compliance to treatment with the main aim of reducing cardiac morbidity rates in the Townsville HHS.” [health.qld.gov.au]

Treatment for rheumatic heart disease: Specific treatment for rheumatic heart disease will be determined by your child's physician based on: Your child's overall health and medical history Extent of the disease Your child's tolerance for specific medications [chw.org]

This can take years to show up, so you may need regular check-ups and further treatment when you're older. [nhs.uk]

Anti-inflammatory treatment Anti-inflammatory treatments include pain medications that are also anti-inflammatory, such as aspirin (Bayer) or naproxen (Aleve, Naprosyn). [healthline.com]

Following an initial diagnosis of ARF, patients require long-term treatment, including long-term antibiotic treatment to avoid further infections that may damage the heart (RHD et al, 2012; AIHW, 2013b). [pmc.gov.au]

Rheumatic fever occurs in equal numbers in males and females, but the prognosis is worse for females than for males. [emedicine.medscape.com]

The average age among participants who died in our study was 29.4 years, confirming the aggressive nature and poor prognosis of RHD in Uganda. [bmccardiovascdisord.biomedcentral.com]

PROGNOSIS OF RHEUMATIC FEVER • Presence or absence of permanent cardiac damage • Cardiac status at the start of treatment • Recurrence of rheumatic fever • Regression of heart disease 41 42. [slideshare.net]

Insights into prognosis of valvular aortic stenosis. Circulation. 1994; 89 (2):642–650. [ PubMed : 8313553 ] Paar J. A., Berrios N. M., Rose J. D., Cáceres M., Peña R., Pérez W., et al. [ncbi.nlm.nih.gov]

Prognosis Rheumatic heart disease occurs in 30-45% of patients with acute RF [ 20 ]. Severe chronic valvular disease is associated with severe carditis and recurrent RF [ 21 ]. [patient.info]

This raises the possibility of an autoimmune etiology. [histopathology-india.net]

The pathogenesis of RHD is complex with both environmental and genetic factors contributing to its etiology. [clinicaltrials.gov]

New observations on the etiology of aortic valve disease: a surgical pathologic study of 236 cases from 1990. Hum Pathol. 1993 Dec. 24(12):1330-8. [Medline]. Veinot JP. Pathology of inflammatory native valvular heart disease. [emedicine.medscape.com]

"Association of Mannose-Binding Lectin Gene Polymorphism but Not of Mannose-Binding Serine Protease 2 with Chronic Severe Aortic Regurgitation of Rheumatic Etiology". Clinical and Vaccine Immunology : CVI 15 (6): 932–936. doi:10.1128/CVI.00324-07. [textbookofcardiology.org]

The etiology of rheumatic fever. Lancet. 1900; 156: 861-869. In article CrossRef [5] Beattie JM. A contribution to the bacteriology of rheumatic fever. J Exp Med. 1907;9: 186-206. [pubs.sciepub.com]

Keywords: rheumatic fever, rheumatic heart disease, group A streptococcus, epidemiology This work is published and licensed by Dove Medical Press Limited. [dovepress.com]

Epidemiologic implications: It is reasonable to consider individuals at low risk of ARF if they come from a setting or population with known low rates of ARF and RHD (Class IIa, Level of Evidence C). [acc.org]

Search Strategy A literature search was performed on PubMed to identify studies that described the epidemiology of acute rheumatic fever and rheumatic heart disease. [pubs.sciepub.com]

OBJECTIVES  To know about the epidemiology of the disease  To understand the pathogenesis of rheumatic heart disease  To know about the clinical features: cardiac & non-cardiac manifestations  To learn about the laboratory studies of RHD  To understand [slideshare.net]

Viral Pharyngitis: Clinical and Epidemiologic Findings Features suggestive of GAS infection Beefy, swollen, red uvula Fever Headache History of exposure to GAS Nausea, vomiting, and abdominal pain Pain with swallowing Patient 5 to 15 years of age Presentation [aafp.org]

Pathophysiology of rheumatic heart disease Micrograph showing an Aschoff body (right of image), as seen in rheumatic heart disease. [textbookofcardiology.org]

Essentials of pathophysiology: concepts of altered health states. Hagerstown, MD: Lippincott Williams & Wilkins. [en.wikipedia.org]

A comprehensive resource provided by the World Health Organization (WHO) addresses the diagnosis and treatment. [1] Pathophysiology Rheumatic fever develops in some children and adolescents following pharyngitis with group A beta-hemolytic Streptococcus [emedicine.medscape.com]

Moreover, heart-M protein cross-reactive T cells have been isolated from the myocardium and the valves of RHD patients suggesting their involvement in the pathophysiology of the disease [ 7, 8 ]. [link.springer.com]

[…] on preventative action, diagnosis and management of acute rheumatic fever and rheumatic heart disease, and should be considered the difinitive source of information to guide all aspects of RHD management, prevention and control across Australia. [healthdirect.gov.au]

Different Preventions of RHD Type of Prevention Aim (What?) Modality (How?) [circ.ahajournals.org]

Quick reference guides cover the following topics: Primary prevention of ARF Diagnosis of ARF Management of ARF Secondary prevention of ARF Management of RHD RHD in pregnancy RHD control programs Access the guidelines and quick reference guides on the [heartfoundation.org.au]

Following ARF diagnosis regular secondary prevention in the form of prophylaxis with antibiotic is started to prevent recurrent ARF and heart damage. [nhp.gov.in]

The best way to prevent repeat episodes of ARF and prevent further damage to heart valves is by having penicillin injections every 21 to 28 days. [healthywa.wa.gov.au]