Chronic rheumatic heart disease what are the symptoms and treatment

The etiology of rheumatism is associated with the consequences of a previous infectious disease, the causative agent of which was streptococcus. The peculiarity of this pathogenic microorganism in its ability to accumulate in the connective tissue in the heart, joints, membranes of the brain and skin. Streptococcus is found in sputum in diseases of the upper respiratory tract: tonsillitis, chronic tonsillitis. Unsanitary oral cavity is also a source of infection.

Beta hemolytic streptococcus is the most dangerous for human health. He is able to destroy red blood cells. Bacteria release strong toxins during their life. Their accumulation leads to the development of complex pathological conditions.

With weakened immunity, chronic foci of infection can provoke the development of acute rheumatic fever. Against her background, changes in the valvular apparatus of the heart occur and an organ defect is formed.

HRBS (chronic rheumatic heart disease) is carditis and heart defects. Without treatment, inflammatory organ diseases lead to heart failure, arrhythmias, and thrombosis.

Most often, rheumatic heart disease appears in patients with tonsillitis, pharyngitis or tonsillitis and is an exacerbation of these pathologies. The etiology is the defeat of the body beta-hemolytic staphylococcus.

According to the nature and location of the lesion, the following types of rheumatic heart disease are distinguished:

  1. heart failure, characterized by incomplete closure of the valve walls;
  2. mitral stenosis – narrowing of the valve opening;
  3. mitral insufficiency;
  4. aortic and mitral valve disease, which occurs together as a combined organ lesion.

Not only bacteria, but also viruses can provoke heart rheumatism.

The etiology of rheumatism is associated with the consequences of a previous infectious disease, the causative agent of which was streptococcus.

The peculiarity of this pathogenic microorganism in its ability to accumulate in the connective tissue in the heart, joints, membranes of the brain and skin. Streptococcus is found in sputum in diseases of the upper respiratory tract: tonsillitis, chronic tonsillitis. Not sanitized oral cavity is also a source of infection.

As a rule, streptococcal infection becomes the cause of rheumatic heart disease. More often these are diseases of the nasopharynx:

According to statistics, acute forms of these diseases cause heart rheumatism in 3% of patients. More often adolescents aged 7 to 16 years, as well as young women and the elderly are sick.

Other causes of pathology:

  • genetic predisposition
  • herpes virus
  • cytomegalovirus
  • measles
  • parotitis
  • Hepatitis B
  • t-lymphotropic viruses

In the connective tissues of the heart muscle, there are cells that are mistaken for immune antibodies as pathogenic bacteria during the fight against infection. Thus, one’s own immunity triggers a pathological process. Due to inflammation, heart valves undergo irreversible changes: stick together and thicken.

The manifestation of this disease is associated with the activity of group A beta-hemolytic streptococcus. These bacteria provoke the appearance of tonsillitis, pharyngitis, and dental caries.

HRBS is preceded by acute rheumatic fever, rheumatic heart disease. The cause of rheumatic pathology of the heart can also be viral diseases.

Classification

The classification of diseases includes myocardial inflammation, pericardium and heart defects. The latter differ among themselves in the features of the defect, which is a consequence of the inflammatory process:

  1. Stenosis (narrowing) of the valves – distinguish between mitral and aortic.
  2. Prolapse of the mitral, aortic valve – due to the deflection of varying degrees, the valve cusps do not close to the end.
  3. Combination of defects in one valve.
  4. The simultaneous defeat of different valves of the body.

The clinical picture is more pronounced, the more the disease progresses. According to the ICD-10 registry (International Classification of Diseases in the 10th revision), CRH is under the number 105-109. This arrangement underlines the high level of threat to the body.

During the diagnosis, the severity of the disease is determined according to the established classification. Types of rheumatic heart disease are divided by phase, severity, and the spread of affected foci.

According to the medical classification, there are 3 phases of rheumatic carditis:

  • Phase 1 (mild) – mild symptoms
  • 2 phase (medium) – moderate symptoms
  • 3 phase (severe) – pronounced symptoms, the last degree of the disease
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Flow options

Rheumatism of the heart can occur in several forms:

  1. Acute – the rapid development of the disease with the presence of pronounced symptoms. In this case, the patient needs urgent medical care.
  2. Subacute – the period of development of the disease is about six months, the intensity of the manifestations is low.
  3. Protracted – the disease lasts from six months or more. In the beginning, the signs are pronounced, but, over time, the manifestations weaken.
  4. Recurrent – the disease passes into this form after several stages of remission. Frequent attacks and rapid progression are observed.
  5. Latent – a latent course of the disease without any signs. As a rule, the disease is detected at the last stage, when a heart defect is already present.

Lesions

Depending on the area of ​​damage, the following forms of rheumatism of the heart are distinguished:

  1. Endocarditis is an inflammation of the inner lining of an organ. Often leads to the development of valve defects, and, as a result – to heart disease. Symptoms are extremely blurred. The disease can be suspected by severe sweating, fever, the appearance of noise in the upper region of the heart and aorta.
  2. Local – pathological changes affect the muscle middle layer of the heart, which is called the myocardium. It is accompanied by chest pain, palpitations, general weakness and increased fatigue. The disease is indicated by changes in the cardiogram and general blood count.
  3. Diffuse – a severe form, which is accompanied by severe shortness of breath, pallor, palpitations, weakness. Systematically, the patient falls into a fainting or fainting state, stagnation in the liver and lungs occurs, the nature of the tones changes when listening.
  4. Endomyocarditis is an inflammatory process that affects the endocardium and myocardium.
  5. Pericarditis is an inflammation of the outer membranes of an organ. This form is rare, difficult to diagnose. It is manifested by pain and noise in the heart, the appearance of shortness of breath, dizziness and weakness.
  6. Pancarditis is an inflammation of the 3 membranes, is quite difficult.
  7. Recurrent rheumatic heart disease – has a protracted course, is difficult to diagnose. Manifestations are similar to myocarditis and endocarditis. The first symptoms occur after the development of heart disease.

Rheumatic heart disease is usually formed in the form of consequences after rheumatic heart disease. In practice, isolated defects are often found, represented by:

  1. Insufficiency (incomplete closure of valve flaps) of the aortic valve.
  2. Mitral stenosis (narrowing of the valve opening).
  3. Mitral insufficiency.
  4. Combined defect of the aortic, mitral valves.
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Signs of the development of pathology

Chronic rheumatic heart disease occurs with a number of characteristic signs. If you look closely at the behavior of a person, his state of health, then you can suspect rheumatic heart damage, and you can confirm the symptoms of the disease by already passing a series of diagnostic measures in the clinic.

Signs of pathology include the following:

  • fatigue syndrome, in which the patient does not feel completely healthy and strong;
  • a constant feeling of weakness that does not go away even after a good rest;
  • the appearance of arrhythmia – a sharp increase or decrease in heart rate, a feeling of sudden compression in the middle of the sternum;
  • swelling of the lower extremities;
  • a feeling of soreness in the heart that a person identifies, but does not yet know what causes pericardial pain;
  • increased heart rate;
  • severe tolerance of changing the climate zone;
  • the appearance of shortness of breath.

Of course, these signs can also indicate many other diseases, but first of all, when they appear, you should contact a cardiologist, since the symptoms of the heart can not be delayed – all cardiac pathologies must be diagnosed and treated in time.

Symptoms in children

As a rule, in children rheumatic heart disease occurs against a background of an upper respiratory tract infection, which is accompanied by an increase in body temperature. Dyspnea and chest pain of low intensity are also observed. Soon, these symptoms disappear, but after a while they come back again. At the second stage of the disease, rheumatic fever occurs, accompanied by signs of:

  • slight increase in temperature
  • breathlessness
  • weakness
  • pain in the head and joints
  • excessive sweating

Often rheumatic fever becomes the first serious symptom that indicates the development of rheumatic heart disease. Over the next three years after repeated fever, damage to the heart walls forms, with the further development of valve defect.

Characteristic symptoms of the disease in children:

  • pain in the heart area of ​​a pressing, burning, stitching nature
  • heart rate
  • swelling of the feet and lower extremities

In some cases, heart damage is asymptomatic. Over time, this pathology can lead to the development of heart disease in the child.

Signs of the development of pathology

Rheumatic pathologies of the heart of chronic origin differ in characteristic symptoms, suggesting the presence of these lesions in the body. In particular, these are:

  • feelings of general weakness;
  • fatigue syndrome;
  • the occurrence of shortness of breath even with light physical exertion;
  • poor tolerance of any climate change;
  • swelling of the extremities;
  • cardiopalmus;
  • arrhythmia;
  • pain of a wide amplitude of severity in the precardium;
  • rheumatic chorea, as well as choreic hyperkinesis.

However, the presence of such signs is possible with many other cardiological diseases. Therefore, having discovered even a few of the above items, you urgently need to consult a specialist.

How to recognize

Symptoms of rheumatic heart disease in each case depend on the area of ​​damage and the severity of the disease.

The main signs of rheumatism of the heart:

  • fatigue and well-being
  • reduced working capacity
  • chest pain
  • rapid pulse
  • periodic arrhythmia
  • excessive sweating
  • in a lying position shortness of breath occurs
  • manifestation of cough during exercise
  • swelling of the legs
  • the skin on the legs becomes cyanotic, or vice versa, a pale shade
  • accumulation of fluid in the peritoneum, which is manifested by an increase in the spleen, liver, volume of the abdomen as a whole
  • noise while listening
  • expansion of the borders of the heart to the left
  • rhythm disturbance according to the electrocardiogram
  • wheezing in the lungs
  • asthma attacks and lack of oxygen
  • thromboembolism – a violation of blood coagulation, the development of blood clots

In the severe stage of rheumatic heart disease, the symptoms are pronounced, circulation is difficult. Characteristic noises are heard, heart failure may develop. The patient is in serious condition, there is a risk of death.

Symptoms in children

A dangerous ailment is coronary heart disease (CHD). It manifests itself as follows:

  1. There are pains behind the sternum; as a rule, they have a piercing character. With the development of an attack, a person seems to bake behind the sternum. The duration of pain is from 2,5 to 16 minutes. If chronic ischemic heart disease worsens, this symptom manifests itself at different intervals.
  2. A sign of coronary heart disease is shortness of breath. It is associated with the fact that the body lacks oxygen. Shortness of breath appears against a background of a pain attack. The peculiarity of the symptom is that it occurs at rest.
  3. Heart rhythm disturbance is also characteristic of coronary heart disease. A rapid heartbeat is observed, while the strokes are quite strong; in other situations, they are weak.
  4. The malaise is accompanied by dizziness. Some people faint.
  5. Ischemia is manifested by profuse sweating, vomiting.
  6. A characteristic sign of the disease is angina pectoris. This is a strong attack, manifested by pain in the chest and abdomen. Sharp pains are also given to the limbs.

Chronic diseases are more difficult to treat. To alleviate the symptoms, you need to eliminate the root causes of the pathology. CHD in the initial stages proceeds hidden.

In addition to this disease, there are many others that are asymptomatic. In this regard, it is necessary to use medical monitoring methods and monitor the patient’s condition.

A common ailment is heart disease. If it progresses, then there is a persistent damage to the heart valve.

A violation of this nature is a sign of chronic rheumatic carditis. It is worth saying that this disease occurs against the background of rheumatic fever.

The cause of chronic rheumatic diseases can be angina. There are cases when the treatment of rheumatic pathology is unsuccessful – then a fatal outcome occurs.

Similar signs may indicate the development of other cardiac pathologies, therefore, if some of them manifest themselves, it is worth consulting a doctor.

Diagnostics

When cardiological complaints appear, the doctor adheres to the following algorithm of actions:

  1. Conducts a visual assessment of patient complaints: the appearance and measurement of blood pressure, heart rate, determination of heart murmur.
  2. The anamnesis includes a history of life and a study of previous diseases. This will help determine the pathogenesis of the development of CRH.
  3. Among the instrumental methods in the first place is an electrocardiogram, according to the results of which one can judge the presence of pathology in the organ. If necessary, it is carried out at rest and after exercise. ECHO cardiography determines hemodynamic disturbances and the type of defect.
  4. Radiography is indicated to determine the size of the ventricles of the heart.

If necessary, the patient is referred for consultation to a rheumatologist, cardiac surgeon.

Diagnosis of the disease includes a number of measures, after passing through which the patient can be accurately told about the presence or absence of rheumatic changes in the heart. Everything is carefully recorded by the patient’s medical history.

At the initial stage, the doctor clarifies the patient’s complaints, inquires in detail about the nature of the pain in the heart, and asks what other disturbances concern the patient. After this, a medical history is collected – the transferred diseases are specified, doctors are especially interested in cases of infectious inflammatory pathologies – tonsillitis, pharyngitis, laryngitis, etc.

After this, the patient’s body is examined, characteristic signs are noted, for example, pallor of the skin, swelling of the limbs, and tiredness in appearance. An electrocardiogram, an echocardiogram is prescribed to patients. Conducted magnetic resonance imaging, catheterization of the cavities of the heart.

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In cases of a latent course of the disease, diagnosis is difficult. Often, patients take possible manifestations of the pathology as a common cold, so they do not go to the doctor on time.

To diagnose rheumatic pains, laboratory and instrumental methods are used:

  1. Studying by the doctor the history of infectious ailments of the patient.
  2. Visual inspection.
  3. Electrocardiogram – indicates a pathological increase in the P-Q interval.
  4. Ultrasound and X-ray – allow you to see the increase in organ size and other important diagnostic indicators.
  5. Phonocardiography – allows you to detect the appearance of noise, a change in the tone of the heart.
  6. Echocardiography – helps to determine the presence of changes in heart valves.
  7. General and biochemical blood tests – help determine the increase in ESR and white blood cells, lower hemoglobin, to detect the presence of fibrinogen and C-reactive protein.
  8. Immunogram – indicates an increase in anti-streptococcal antibodies and anticardial bodies, a change in the level of certain immunoglobins.

Based on the data obtained, a diagnosis is made, the complexity of the disease is determined, and then treatment is prescribed. Therapy is aimed at relieving inflammation, eliminating heart failure, improving the functioning of the cardiovascular system.

Diagnosis of such an ailment as chronic rheumatic heart disease includes such measures:

  1. Clarification of complaints.
  2. History taking.
  3. Examination of the patient.
  4. Echocardiography.
  5. Magnetic resonance imaging .
  6. Electrocardiography
  7. Cardiac catheterization.

Methodology of treatment: ways of medical and surgical intervention

In drug treatment of chronic rheumatic heart disease in modern medicine, as a rule, the complex use of blocking and restoring drugs is prescribed. In particular, chronic heart failure is stopped by the use of angiotensin converting enzyme inhibitors, beta-blockers, cardiac glycosides, and diuretics.

The spectrum of antiarrhythmic drugs is prescribed for cardiac arrhythmias, they also use means to normalize blood pressure. In the treatment of heart defects, medications that thin the blood and facilitate blood flow, preventing vascular thrombosis.

With some particularly complex manifestations of rheumatic disorders, surgical intervention is also practiced, as the most radical measure. The main types of surgical operations for this disease: prosthetics of the valve wall, and dissection of the narrowed valve leaflet. Do not be afraid of surgery if necessary.

It is also worth noting that the statistics for the treatment of chronic rheumatic diseases has recently improved significantly: the number of patients with positive dynamics of the pathology is gradually increasing, as evidenced by the statistics of medical studies.

How is the treatment carried out?

Depending on the clinical symptoms of the disease, the doctor may prescribe medication; in severe cases, surgery is recommended. The patient for a certain time takes medications that restore the heart.

Chronic heart failure is stopped by taking beta-blockers, cardiac glycosides. If necessary, the doctor prescribes inhibitors, diuretics.

If there is a violation of the heart rhythm, then antiarrhythmic drugs are used; in addition to them, funds are prescribed to normalize the pressure.

To treat heart disease, drugs are used that thin the blood, improve blood flow, and prevent thrombosis. If it is not possible to cure the pathology or at least achieve its regression, then an operation is prescribed.

Surgery is a radical measure of treatment. It may involve prosthetics of the valve or dissection of the leaflet that has been narrowed. There are times when surgery is indispensable.

Modern heart surgery gives few side effects, since most of them are performed using a laser beam.

The advantages of the procedure are that a person has a reduced period of resuscitation.

Cardiology is developing rapidly, and there are many methods to achieve positive dynamics in the treatment of heart disease.

With timely contact to a medical institution, the course of treatment of the acute or subacute stage of the disease in a hospital is from 2 weeks to 2 months. A neglected form of the disease cannot be completely cured – from time to time the symptoms of the pathology will disturb the patient.

Treatment methods for rheumatic heart disease:

  • drug treatment
  • physiotherapy and spa treatment
  • physiotherapy
  • diet No. 1
  • preventive measures: hardening, airing the premises, frequent walks in the fresh air, timely elimination of focal infections, protecting the patient from other patients infected with streptococcus, systematic observation by a doctor

The treatment methods for acute and protracted rheumatism are different. With a heart defect formed, surgical treatment may be necessary.

Acute phase

During treatment, bed rest is indicated. Drug therapy involves the introduction of injections of penicillin-containing drugs for 2 weeks. If the patient has an individual intolerance to penicillin, a course of treatment with erythromycin will be required.

Also at the discretion of the doctor are appointed:

  • acetylsalicylic acid or analogues to relieve inflammation
  • non-steroidal anti-inflammatory drugs
  • immunosuppressants
  • gamma globulins

Therapy is carried out exclusively under the supervision of a doctor, preferably in a hospital setting.

Long form

In the presence of a protracted form of rheumatism, the patient is prescribed courses of treatment with quinoline series drugs: plaquenil, dilagil. The approximate duration of therapy is 1-2 years.

If necessary, are assigned:

  • immunosuppressants provided daily monitoring of changes in blood composition
  • gamma globulins in combination with desensitizing drugs
  • diuretics
  • glycosides
  • vitamins

In the treatment of protracted rheumatic heart disease, physiotherapeutic procedures are indicated to relieve inflammation and improve blood circulation: therapeutic mud baths, exposure to ultraviolet light, massage, electrophoresis. After the main treatment in a hospital, the patient is shown the passage of sanitary-resort treatment courses, as well as preventive measures.

Treatment of chronic rheumatic heart disease is performed using the following methods:

  • Therapeutic;
  • Medication;
  • Operational;
  • Folk remedies.

Therapeutic

Therapeutic treatment is carried out in order to eliminate the causes of the disease. Its foundation is to strengthen the heart muscle through medication.

Medication

A cardiologist prescribes drugs with:

  • antiarrhythmic action (“Bisoprolol”);
  • diuretic effect.
  • anticoagulants (indirect). These include Warfarin;
  • diuretics (“Hydrochlorothiazide”);
  • cardiac glycosides;
  • antihypertensive, antianginal drugs (“Amlodipine”).

Operation

Doctors resort to surgical treatment in the absence of the effect of drug therapy. Surgical treatment is prescribed in 70% of cases.

It involves the dissection of the valves, prosthetics of the heart valves, stenting of the coronary arteries. The patient returns to a full life some time after the operation.

Folk methods

As medicines in traditional medicine, various tinctures are used:

  1. Calendula tincture, which is prepared from 10-15 g of cut leaves. Leaves are poured with a liter of vodka, stand for about 3 days. Take twice / thrice a day, 20-30 ml. The tool improves the functioning of CVS, strengthens the heart muscle.
  2. Tincture of mother and stepmother, which is prepared from 20 g of leaves. They are poured with a liter of boiling water. Use twice a day 15-20 ml.
  3. Tincture of hawthorn, which is prepared from 2 tsp. leaves. The leaves are poured with boiling water, insist in the cold for a day. Drink twice a day 5-10 ml. This tool saturates the body with useful trace elements, increases the efficiency of the heart.
  4. Tincture of motherwort, which is prepared from crushed leaves. They are poured with a liter of boiling water, insist for a day. It is used twice / thrice a day. It has a calming effect, improves the functioning of blood vessels, heart.

Prevention and recommendations for such an ailment as chronic rheumatic heart disease are given below.

Disease therapy

Treatment of HRBC can be conservative and surgical. The following symptomatic drugs are used as medications:

  • hypertension medications;
  • diuretics;
  • vasodilator drugs;
  • cardiac glycosides;
  • drugs with anticoagulant effect.

The treatment regimen, the dosage of drugs is selected individually. If necessary, it can be adjusted in the absence of positive dynamics or the development of an allergic reaction.

Plastic surgery using cylinders is performed for patients with elastic valve flaps. During surgery, a catheter is inserted into the septum between the atria. The cylinder is installed at the narrowing point to increase the space. Such measures are resorted to delay valve replacement. The risks are minimal, the operation is performed, including for women during pregnancy.

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With severe calcification, replace the valve with an artificial one. After surgery, it is necessary to control blood coagulation in order to avoid thromboembolism.

Dissection of the valves or installation of valve prostheses is performed in severe cases of the disease and the progression of the disease, despite the use of drugs.

The disease can be treated with conservative or surgical techniques. Therapeutic treatment is based on the use of drugs to eliminate the causes of pathology. Their action is aimed at strengthening the heart muscle and stabilizing its work.

Among the medications that are prescribed during therapy, we note:

  • antiarrhythmic drugs – these include bisoprolol;
  • drugs with a diuretic effect;
  • anticoagulants, for example, warfarin;
  • drugs to reduce high blood pressure.

Surgery is resorted to in more than half of cases, especially if the pathogenesis of the disease is burdened. This does not give hope for a resolution of the situation using conservative methods, so doctors are considering the possibility of surgical intervention.

  1. hypertension medications
  2. diuretics
  3. vasodilator drugs,
  4. cardiac glycosides,
  5. drugs with anticoagulant effect.

Complications

If the physical activity is not excessive, the patient will not feel pain behind the sternum, irregularities in the rhythm of the heart. Pulmonary edema can provoke pneumonia, stress, atrial fibrillation. During a coughing fit, bronchial veins may rupture, sputum is stained with blood. The chronic course of the disease can lead to the formation of a blood clot, which, together with the blood stream, enters other organs and the vascular bed.

As a result of an acute inflammatory process, valve flaps are affected. If therapy is ineffective, the edges of the cusps thicken, tendons and muscles are involved in the process. Subsequently, the valve structure changes, its mobility is limited due to calcification and muscle shortening.

Against the background of rheumatic lesions, the openings of the heart valves are halved. The reason for the appearance of shortness of breath is the creation of additional pressure for the passage of blood through the circle of blood circulation.

A frequent complication of rheumatism is the rapid destruction of heart valves. Pathological changes lead to narrowing of the openings between the chambers, as well as to valve insufficiency. As a result of these problems, blood clots occur that provoke dangerous diseases: thromboembolism, heart attack, stroke. During the progression of rheumatism, the functionality of the heart muscle deteriorates.

The development of chronic rheumatoid damage to the heart muscles is possible in several forms. One of the most common is the form of stenosis, when the valve opening in the heart narrows, which leads to irreversible changes in the blood flow. Manifestations are also possible (valve flaps close, but not completely).

Quite often, combinations of a different nature of lesions of one or more heart valves are also observed. As a rule, it is these combinations of disorders that are most dangerous and most difficult to treat. But, subject to timely diagnosis and regular medical supervision, even the most complex foci of manifestation of heart defects can be extinguished and the risk of a threat to the life of the patient can be minimized.

In the event that a chronic rheumatic disease progresses, it can lead to a number of undesirable complications. For example, the occurrence of chronic heart failure, arrhythmic disturbances, the occurrence of thrombo-ebolic phenomena, including stroke. Predictable complications also include infectious endocarditis, a dangerous cardiological disease accompanied by deep damage to the heart tissue.

Prevention of rheumatism

Distinguish between primary and secondary events. How to prevent acute rheumatic fever:

  1. Observe the correct mode of work and rest. Sleep should be complete, and rest active in the fresh air. Sports should be aimed at strengthening the heart muscle – it can be running, water aerobics, swimming.
  2. Prevent the occurrence of chronic foci of infection in the body, sanitize them on time.
  3. Do not tolerate infectious diseases on the legs, therapy should be adequate and prevent bacterial complications.

In order to prevent relapse of rheumatism and aggravation of the existing pathology, secondary prevention includes:

  • observation by a doctor during periods of remission;
  • the use of antibiotics of accumulative action for several years after the initial disease;
  • thorough hygiene of the oral cavity, mucous membranes of the upper respiratory tract after surgical treatment of teeth, removal of tonsils.

The prognosis for the timely conduct of proper treatment is relatively favorable. The level of development of modern medicine significantly improves the quality of life and prolongs it for cardiological patients. Do not self-medicate, the specialist should deal with the treatment of the disease and complications.

As you know, the disease is easier to prevent than to treat, so the prevention of rheumatic heart disease is given a key position.

Secondary prevention consists in compliance with measures that do not allow the disease to worsen if acute rheumatic heart disease has already been diagnosed. Patients with a certain periodicity for five years are given antibacterial drugs. This will prevent the development of bacterial endocarditis.

  1. medical supervision during periods of remission,
  2. the use of antibiotics of accumulative action for several years after the initial disease,
  3. thorough hygiene of the oral cavity, mucous membranes of the upper respiratory tract after surgical treatment of teeth, removal of tonsils.

A lot of attention is given to preventive measures.

  1. Primary It is necessary to prevent the development of acute rheumatic fever and consists in organizing proper nutrition, introducing it into the schedule of outdoor recreation, and hardening. Also, the patient eliminates various foci of infection (adenoids, caries, tonsillitis). In the presence of a viral infection, bed rest is prescribed.
  2. Secondary It is carried out in order to prevent the occurrence of relapses, to avoid the progression of the disease, rheumatic fever. It consists in the periodic administration of antibiotics for 5 years, the prevention of bacterial endocarditis.

Forecast

If acute or chronic rheumatic heart disease was detected in a timely manner and qualified medical care was provided to the patient, the prognosis is favorable. In most cases, after proper therapy, the functionality of the heart and its departments is fully restored. There is a likelihood of developing heart disease, which will subsequently make itself felt unpleasant symptoms.

The possibility of death from heart failure caused by rheumatic heart disease is rather low. According to statistics, death occurs in only 0,1-0,5% of cases. In the presence of other cardiovascular pathologies, as well as with increasing age, the prognosis for the patient may worsen.

Violations of cardiohemodynamics in some cases can be eliminated only through surgical intervention. To increase the speed of the rehabilitation period of patients, adequate treatment should be carried out after establishing an etiological, topical diagnosis. The prognosis for the timely conduct of proper treatment is relatively favorable.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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