Mild aortic regurgitation (AR) was also present. Blood cultures remained sterile; however, she received a course of penicillin prior to her hospital presentation. Antibiotics followed for culture-negative endocarditis. [bloodjournal.org]

In five valves, the helper T cells exceeded the number of suppressor T cells, whereas in three others, helper and cytotoxic/suppressor T cells were present in equal numbers. [ncbi.nlm.nih.gov]

Through the case of a 41-year-old Caucasian female who presented with progressive dyspnea and symptoms of heart failure, due to subacute rheumatic valvulitis, the importance of multimodality cardiovascular imaging assessment of patients presenting with [ingentaconnect.com]

After two years, the patient presents chest pain and dyspnea on major exertion. [scielo.br]

• Fever

  Infections with these bacteria begin as strep throat or scarlet fever and evolve into Acute Rheumatic Fever if they are not treated. [novusbio.com]

  usually rheumatic fever or syphilis. [medicine.academic.ru]

  A 6-yr-old female with profound respiratory failure found to be due to mitral valve dysfunction stemming from acute fulminant rheumatic fever. [journals.lww.com]

  Such inflammation may occur without clinical suspicion of active rheumatic fever. [ncbi.nlm.nih.gov]

  Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2nd ed. Darwin: Menzies School of Health Research; 2012. [cited 2017 Mar 1] Combined rheumatic fever study group. [nps.org.au]

• Inflammation

  The high incidence of active valvulitis supports the concept that chronic fibrosing rheumatic valvular disease results from recurrent active inflammation. Such inflammation may occur without clinical suspicion of active rheumatic fever. [ncbi.nlm.nih.gov]

  Pathol. inflammation of a valve, esp. a heart valve, often caused by rheumatic fever. [1890 95; VALVULE + ITIS] * * * … Universalium valvulitis — n. inflammation of one or more valves, particularly the heart valves. [medicine.academic.ru]

  [ModL < valvula (see VALVULE) + ITIS] inflammation of a valve, esp. of the heart … English World dictionary valvulitis — Inflammation of a valve, especially a heart valve. [Mod. [esacademic.com]

  Most common in children between the ages of 5 to 15, the symptoms of Acute Rheumatic Fever with Valvulitis include chest pain and heart inflammation. [novusbio.com]

  Rheumatic heart disease Chronic rheumatic heart disease (RHD) is characterized by repeated inflammation with fibrinous resolution. [textbookofcardiology.org]

• Congestive Heart Failure

  New to the third edition are: - Expanded coverage of the coronary heart disease syndromes; congestive heart failure; arrhythmias; pacing; sudden death; lipid management (including clinical results), and a completely revised and updated section on noninvasive [books.google.de]

  Rheumatic heart disease chronically manifests as congestive heart failure from valvular involvement. Most commonly the mitral valve is affected, resulting in mitral stenosis or mitral regurgitation. [healio.com]

  A 13-year-old girl was admitted with congestive heart failure, edema, ascites, and jaundice. There was an apical pansystolic murmur of mitral insufficiency and marked cardiomegaly. Her venous pressure was elevated. [ncbi.nlm.nih.gov]

  A S3 gallop indicates left-sided congestive heart failure. [atsu.edu]

• Disability

  Child for Rehabilitative Services; Severe Traumatic Brain Injury; Spinal Cord Injury and Autonomic Crisis Management; Spasticity; Birth Brachial Plexus Palsy; Traumatic and Sports-Related Injuries; Meningomyelocele; Health and Wellness for Children with Disabilities [books.google.de]

  "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". [en.wikipedia.org]

  Epidemiology Disability-adjusted life year for rheumatic heart disease per 100,000 inhabitants in 2004.[ 24 ] no data less than 20 20–40 40–60 60–80 80–100 100–120 120–140 140–160 160–180 180–200 200–330 more than 330 Rheumatic fever is common worldwide [textbookofcardiology.org]

  Keywords: Doppler echocardiography, prognosis, rheumatic fever, rheumatic valvular disease INTRODUCTION Even in the 21 st century, acute rheumatic fever (RF) and chronic rheumatic heart disease (RHD) remain the major cause of cardiovascular disability [ncbi.nlm.nih.gov]

• Malaise

  In addition to nonspecific symptoms (e.g., fever, malaise, and fatigue), patients present with symptoms involving the heart (pancarditis), joints (migratory polyarthritis), skin (subcutaneous nodules, erythema marginatum ), and/or CNS ( Sydenham's chorea [amboss.com]

  Five years later (October 1991), the patient was admitted with fever, general malaise and conjunctival petechiae. [scielo.br]

  Fatigue, anorexia, weakness, myalgias, arthralgias and malaise are common. Debilitating low back pain is a prominent complaint in a small percentage of patients. Acute endocarditis has a rapid onset (e.g., hours to days) of signs and symptoms. [atsu.edu]

• Dyspnea

  Through the case of a 41-year-old Caucasian female who presented with progressive dyspnea and symptoms of heart failure, due to subacute rheumatic valvulitis, the importance of multimodality cardiovascular imaging assessment of patients presenting with [ingentaconnect.com]

  At age 33, dyspnea on minimal exertion reappeared. [scielo.br]

  A 17-year-old girl with history of dyspnea on exertion and palpitation of 20 days was admitted for evaluation. There was no history of joint pain or swelling or respiratory tract infection in the preceding 1 month. [heartindia.net]

  In severe cases, patients may complain of dyspnea, mild-to-moderate chest discomfort, pleuritic chest pain, edema, cough, or orthopnea. [atsu.edu]

• Strawberry Tongue

  It is usually heard by the doctor while… … Medical dictionary Kawasaki disease — Classification and external resources A child showing characteristic strawberry tongue seen in Kawasaki disease ICD 10 M … Wikipedia Diastolic heart murmur — Auscultogram [medicine.academic.ru]

• Heart Disease

  […] with severe heart disease. [nps.org.au]

  See Rheumatic Heart Disease and Rheumatic Fever for more information. [emedicine.medscape.com]

  unspecified I10 Essential (primary) hypertension I11 Hypertensive heart disease I11.0 Hypertensive heart disease with heart failure I11.9 Hypertensive heart disease without heart failure I12 Hypertensive chronic kidney disease Reimbursement claims with [icd10data.com]

  Health Rheumatic Heart Disease Register of Western Australia Regulations 2015 (PDF 304KB) Guidelines SONG (external site) RHD Australia, The Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease [ww2.health.wa.gov.au]

• Heart Failure

  The presence of rheumatic heart disease and cardiomegaly may have led to the exacerbation of symptoms and signs of constrictive pericarditis and severe right heart failure. [ncbi.nlm.nih.gov]

  New to the third edition are: - Expanded coverage of the coronary heart disease syndromes; congestive heart failure; arrhythmias; pacing; sudden death; lipid management (including clinical results), and a completely revised and updated section on noninvasive [books.google.de]

  Rheumatic heart disease chronically manifests as congestive heart failure from valvular involvement. Most commonly the mitral valve is affected, resulting in mitral stenosis or mitral regurgitation. [healio.com]

  Through the case of a 41-year-old Caucasian female who presented with progressive dyspnea and symptoms of heart failure, due to subacute rheumatic valvulitis, the importance of multimodality cardiovascular imaging assessment of patients presenting with [ingentaconnect.com]

  Because of the common occurrence in developing countries, access to medical procedures is limited; subsequently, many children die of heart failure from Acute Rheumatic Fever with Valvulitis each year. [novusbio.com]

• Heart Murmur

  […] from normal and abnormal heart sounds Diastolic heart murmurs are heart murmurs heard during diastole.[1] … Wikipedia verrucous vegetations — small irregular fibrinous excrescences usually occurring along the line of closure of the cardiac valve cusps [medicine.academic.ru]

  Defects, Congenital, Heart Murmurs, Incidence, Mitral Valve Insufficiency, Myocarditis, Pharyngitis, Polysaccharides, Bacterial, Pharynx, Prevalence, Rheumatic Fever, Rheumatic Heart Disease, Streptococcal Infections, Streptococcus pyogenes, Streptolysins [acc.org]

  Nearly all patients will have an audible heart murmur. Although classically described as a changing murmur the murmur usually does not change significantly over time unless a valve leaflet is destroyed or a chordae tendineae ruptures. [atsu.edu]

  Carditis: pancarditis  Pericardial friction rubs  Weak heart sounds  Tachycardia & arrhythmias  New heart murmurs. other clinical features include epistaxis & abdominal pain. 24.  Myocarditis may cause cardiac dilatation leading to mitral valve insufficiency [slideshare.net]

  Only two patients with subclinical valvulitis developed heart murmur during the follow-up, after recurrence with carditis. [ncbi.nlm.nih.gov]

• Systolic Murmur

  This picture together with a systolic murmur, pericardial friction rub and an ESR of 118 mm/h prompted a transesophageal echocardiogram (TEE) revealing a myxomatous mitral valve (MV) with severe MR and thickening of the tip of the posterior leaflet of [bloodjournal.org]

  This case does not present a better description of systolic murmur audible in the aortic area. [scielo.br]

  The cardiovascular system examination showed normal heart sounds, S1 soft, 3/6 presystolic murmur at the apex radiating to the axilla, 2/6 systolic murmur at the left lower sternal border and in the pulmonary area, and 2/6 diastolic murmur in the apex [heartindia.net]

  Case Report A 10-year-old female child was referred for echocardiographic evaluation with an apical systolic murmur. [scirp.org]

• Diastolic Murmur

  The murmur is described as a mid-diastolic murmur heard at the mitral listening post with the bell of the stethoscope with the patient in the left lateral decubitus position at end expiration. [healio.com]

  The cardiovascular system examination showed normal heart sounds, S1 soft, 3/6 presystolic murmur at the apex radiating to the axilla, 2/6 systolic murmur at the left lower sternal border and in the pulmonary area, and 2/6 diastolic murmur in the apex [heartindia.net]

  Physical examination in primary care (May 1977) revealed pulse rate of 80 bpm, blood pressure 100/0 mmHg; auscultation was normal, cardiac auscultation revealed systolic murmur +++/ 4+ in the aortic area and diastolic murmur in the left sternal border [scielo.br]

• Arthritis

  MPO-ANCA necrotizing glomerulonephritis related to rheumatoid arthritis. Am J Kidney Dis, 32 (1998), pp. E6 [10.] M.U. Qarni, D.E. Kohan. Pauci-immune necrotizing glomerulonephritis complicating rheumatoid arthritis. [reumatologiaclinica.org]

  {New Latin valvula valvule + itis} … Australian English dictionary Rheumatoid arthritis — Classification and external resources A hand affected by rheumatoid arthritis ICD 10 M … Wikipedia Murmur — A Murmur is an abnormal "whooshing" sound created by [medicine.academic.ru]

  (35-66%) Rates of arthritis tend to increase w/ age. [hopkinsguides.com]

  In 5/03, she was admitted with acute arthritis of the left hip and pain in her left shoulder and hands. [bloodjournal.org]

  arthritis and age of patients at the initial attack ≤10 years. [ncbi.nlm.nih.gov]

• Excitement

  This classic Netter reference has been updated to mirror the many exciting advances in cardiovascular medicine and imaging – offering unparalleled insights into anatomy, physiology, and clinical conditions. [books.google.de]

  Atrial myocardial cells extended into the base of the leaflets and had dense innervations and excitability, suggesting a neural regulatory mechanism [5]. [scirp.org]

• Polyneuropathy

  Associated Infections; Intrapartum and Peripartum Infections; Bath salts and other drugs of abuse; Small Fiber Polyneuropathy; Microbiome; Kingella kingae; Mitochondrial Neurogastrointestinal Encephalomyopathy; Nonalcoholic Fatty Liver Disease; Plagiocephaly [books.google.de]

• Catatonia

  […] techniques and approaches with complete updates throughout 35 new chapters, including: Innovations in Addressing Child Health and Survival in Low Income Settings; Developmental Domains and Theories of Cognition; The Reggio Emilia Educational Approach Catatonia [books.google.de]

• Kingella

  Associated Infections; Intrapartum and Peripartum Infections; Bath salts and other drugs of abuse; Small Fiber Polyneuropathy; Microbiome; Kingella kingae; Mitochondrial Neurogastrointestinal Encephalomyopathy; Nonalcoholic Fatty Liver Disease; Plagiocephaly [books.google.de]

  We do not rule out endocarditis by HACEK etiologic agents ( Haemophilus spp, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella kingae ) 8,9. At age 33, dyspnea on minimal exertion reappeared. [scielo.br]

  (usually Staphylococcus aureus ), Enterococcus Gram-negative bacilli, HACEK group ( Haemophilus aphrophilus Haemophilus parainfluenzae or Haemophilus paraphrophilus, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella [atsu.edu]

Holmes Springer Science & Business Media, 06.12.2007 - 2926 Seiten Cardiovascular Medicine, 3rd Edition offers the most up-to-date, user-friendly guidance on the evaluation, diagnosis and medical and surgical treatment of heart and vascular disease and [books.google.de]

The first-line treatment is penicillin, and is combined with symptomatic anti-inflammatory treatment, typically with salicylates or glucocorticoids (if salicylates are not effective). [amboss.com]

This is in contrast to the recommendation for azithromycin treatment of acute group A streptococcal infection. [nps.org.au]

Despite medical treatment her condition deteriorated, hepatic and renal failure as well as disseminated intravascular coagulation ensued, leading to her death. [ncbi.nlm.nih.gov]

Abstract The prognosis for 115 rheumatic fever patients subsequently receiving regular intramuscular penicillin prophylaxis for at least 5 years was studied. Average follow-up was 9.3 years, and 57 patients were followed for 10 years or longer. [circ.ahajournals.org]

References: [4] [16] [17] Prognosis Prevention Primary prevention : prompt antibiotic treatment (e.g., penicillin V ) of GAS tonsillopharyngitis diagnosed by throat culture or rapid strep test Secondary prevention Antibiotic prophylaxis to prevent recurrence [amboss.com]

The presence of arthritis as well as the presence of chorea in the initial attack were related to a better prognosis in relation to significant valvular heart disease. [ncbi.nlm.nih.gov]

Microscopic polyarteritis: presentation, pathology and prognosis. Q J Med, 56 (1985), pp. 467-483 [5.] J.C. Jennette, R.J. Falk, K. Andrassy, P.A. Bacon, J. Churg, W.L. Gross, et al. Nomenclature of systemic vasculitides. [reumatologiaclinica.org]

PROGNOSIS In cases of primary attack is excellent with only 1% cases dying from fulminant RF 25. [slideshare.net]

The pathologic picture of pericarditis was nonspecific, but in presence of a positive skin test for tuberculosis the latter is considered to be the most likely cause of the pericarditis, nevertheless, rheumatic etiology of pericarditis in this case cannot [ncbi.nlm.nih.gov]

Etiology Streptococcus pyogenes (group A Streptococcus ) is the etiological agent that induces an autoimmune reaction that results in damage to the heart. This complication occurs several weeks after a pharyngeal infection with S pyogenes. [atsu.edu]

Possibly the etiology of such involvement is by extemporaneous development of rheumatic fever, with late involvement of this valve. [scielo.br]

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]

Etiology Most commonly accepted mechanism : Group A β-hemolytic streptococcus ( Streptococcus pyogenes ) (G AS) : ac ute tonsillitis or pharyngitis (“ strep throat ”) without antibiotic treatment → antibodies develop against streptococcal M protein → [amboss.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]

References: [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Changes in the clinical and epidemiological features of group A streptococcal bacteraemia in Australia’s Northern Territory. Trop Med Int Health 2015;20:40-7. Kim S, Lee NY. [nps.org.au]

Epidemiology Forced exercise, pregnancy, use of steroids or nonsteroidal anti-inflammatory agents, use of ethanol, and nutritional deficiencies are factors that predispose a patient to symptomatic myocarditis. [atsu.edu]

Rheumatic chorea in northern Australia: a clinical and epidemiological study. Arch Dis Child. 1999; 80 :353–8. [ PMC free article ] [ PubMed ] [ Google Scholar ] [ncbi.nlm.nih.gov]

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

Neuropsychiatric symptoms (e.g., inappropriate laughing/crying, agitation, anxiety, apathy, obsessive-compulsive behavior) Epidemiology ♀ < ♂ ( ∼ 2:1 ) Longer latent period than other rheumatic manifestations (presents several months following GAS infection ) Pathophysiology [amboss.com]

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

Ann Rev Med. 1989; 40: 201-211 Scopus (22) PubMed Crossref Google Scholar Selzer A Katayama F Mitral regurgitation: clinical patterns, pathophysiology, natural history. [internationaljournalofcardiology.com]

References: [4] [16] [17] Prognosis Prevention Primary prevention : prompt antibiotic treatment (e.g., penicillin V ) of GAS tonsillopharyngitis diagnosed by throat culture or rapid strep test Secondary prevention Antibiotic prophylaxis to prevent recurrence [amboss.com]

Timor Leste). 34 This adds a further challenge to the prevention of this serious and potentially fatal condition. [nps.org.au]

Treatment of Group A strep throat even 9d after onset is still effective in prevention of ARF. To prevent recurrent attacks of GAS infection and therefore ARF. [hopkinsguides.com]

No patient developed mitral or aortic stenosis: this suggests that regular prophylaxis may prevent the development of stenosis. [circ.ahajournals.org]

[…] comprehensive coverage of every aspect of cardiovascular medicine from cardiac signs and symptoms and the full range of cardiac imaging techniques through management of peripheral vascular disease and the genetic basis for cardiovascular disease to preventive [books.google.de]