Rheumatic heart disease - Revision history

Aidan at 15:58, 20 February 2026

2026-02-20T15:58:32Z

← Older revision		Revision as of 15:58, 20 February 2026
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	* Almost always affects the mitral valve with isolate mitral stenosis being the most common		* Almost always affects the mitral valve with isolate mitral stenosis being the most common
	* Mitral regurgitation, aortic stenosis, and aortic regurgitation also possible		* Mitral regurgitation, aortic stenosis, and aortic regurgitation also possible
	* Acute rheumatic fever can cause inflammation of essentially any part of the heart		* [[Acute rheumatic fever]] can cause inflammation of essentially any part of the heart

	==Investigations==		==Investigations==

Aidan: /* Management */

2021-12-22T01:19:25Z

Management

← Older revision		Revision as of 01:19, 22 December 2021
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	*Acute		*Acute
	**Antibiotics		**Antibiotics
	***First-line: penicillin V for 10 days		***First-line: [[penicillin V]] for 10 days
	***Alternative: amoxicillin for 10 days		***Alternative: [[amoxicillin]] for 10 days
	**If carditis, add antiinflammatory		**If carditis, add antiinflammatory
	***First-line: high-dose ASA 20mg/kg?? (~1.3g) po qid		***First-line: high-dose [[ASA]] 20mg/kg?? (~1.3g) po qid
	***Alternative: prednisone 1g/kg po daily with a 9-week taper		***Alternative: [[prednisone]] 1g/kg po daily with a 9-week taper
			*Prophylaxis, including patients with mild latent disease on echo
	*Prophylaxis
	**~~Penicillin~~ 1.2mU IM q3-4week		**[[Benzathine penicillin G]] 1.2mU IM q3-4week

	[[Category:Cardiology]]		[[Category:Cardiology]]

Aidan at 16:31, 12 February 2021

2021-02-12T16:31:54Z

← Older revision		Revision as of 16:31, 12 February 2021
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	== ~~Definition~~ ==		==Background==

	* Delayed autoimmune reaction to group A streptococcal pharyngitis		*Delayed autoimmune reaction to group A [[streptococcal pharyngitis]]

			===Pathophysiology===
	== Epidemiology ==

		⚫	*Cross-reactivity of anti-streptococcal antibodies with interstitial cardiac valvular cells
⚫	* Occurs in about 3% of cases of untreated streptococcal pharyngitis

	== ~~Etiology~~ ==		=== Epidemiology ===

		⚫	*Occurs in about 3% of cases of untreated [[streptococcal pharyngitis]]
⚫	* Cross-reactivity of anti-streptococcal antibodies with interstitial cardiac valvular cells

	== ~~Investigations~~ ==		== Clinical Manifestations ==

			* Almost always affects the mitral valve with isolate mitral stenosis being the most common
⚫	* Anti-streptolysin-O titre (ASOT)
			* Mitral regurgitation, aortic stenosis, and aortic regurgitation also possible
⚫	** >116 is suggestive of recent group A streptococcal infection
			* Acute rheumatic fever can cause inflammation of essentially any part of the heart

	== ~~Complications~~ ==		==Investigations==

		⚫	*Anti-streptolysin-O titre (ASOT)
⚫	* Carditis leading to rheumatic heart disease in 30-45% of cases
		⚫	**>116 is suggestive of recent group A streptococcal infection

	== ~~Management~~ ==		==Complications==

		⚫	*Carditis leading to rheumatic heart disease in 30-45% of cases
⚫	* Acute

⚫	** Antibiotics
			==Management==
⚫	*** First-line: penicillin V for 10 days

⚫	*** Alternative: amoxicillin for 10 days
		⚫	*Acute
⚫	** If carditis, add antiinflammatory
		⚫	**Antibiotics
⚫	*** First-line: high-dose ASA 20mg/kg?? (~1.3g) po qid
		⚫	***First-line: penicillin V for 10 days
⚫	*** Alternative: prednisone 1g/kg po daily with a 9-week taper
		⚫	***Alternative: amoxicillin for 10 days
⚫	* Prophylaxis
		⚫	**If carditis, add antiinflammatory
⚫	** Penicillin 1.2mU IM q3-4week
		⚫	***First-line: high-dose ASA 20mg/kg?? (~1.3g) po qid
		⚫	***Alternative: prednisone 1g/kg po daily with a 9-week taper
		⚫	*Prophylaxis
		⚫	**Penicillin 1.2mU IM q3-4week

	[[Category:Cardiology]]		[[Category:Cardiology]]

Maintenance script: Imported from text file

2020-07-04T01:17:54Z

Imported from text file

New page

== Definition ==

* Delayed autoimmune reaction to group A streptococcal pharyngitis

== Epidemiology ==

* Occurs in about 3% of cases of untreated streptococcal pharyngitis

== Etiology ==

* Cross-reactivity of anti-streptococcal antibodies with interstitial cardiac valvular cells

== Investigations ==

* Anti-streptolysin-O titre (ASOT)
** >116 is suggestive of recent group A streptococcal infection

== Complications ==

* Carditis leading to rheumatic heart disease in 30-45% of cases

== Management ==

* Acute
** Antibiotics
*** First-line: penicillin V for 10 days
*** Alternative: amoxicillin for 10 days
** If carditis, add antiinflammatory
*** First-line: high-dose ASA 20mg/kg?? (~1.3g) po qid
*** Alternative: prednisone 1g/kg po daily with a 9-week taper
* Prophylaxis
** Penicillin 1.2mU IM q3-4week

[[Category:Cardiology]]
[[Category:Infectious diseases]]