Rheumatic Heart Disease

• Rheumatic Heart Fever 

  Causative agent: group A betahemolytic streptococcus (GABHS)
• GABHS renal complication: Acute Glomerolunephritis
• GABHS migration to organs take 2 weeks
• Rheumatic Heart Fever is diagnosed using Jones Criteria 

  • 2 major + Hx
  • 1 major + 2 minor + Hx
• Rheumatic Heart Fever drug of choice: Penicillin taken for 5-10 days
• Penicillin substitute if with allergy: Clindamycin, Erythromycin
• Rheumatic Heart Fever DoC for pain and swelling: Salicylates
• Rheumatic Heart Fever DoC for relieving carditis: Corticosteroids
• Most important nursing responsibility for aspirin: Assess for bleeding
• Jones Major Criteria for Rheumatic Heart Fever mnemonic: CASES
• Rheumatic Heart Fever

  Jones Major Criteria (CASES)

  • C - Carditis
  • A - Arthritis, poly
  • S - Subcutaneous Nodules (seen in areas with less SC such as bony prominences)
  • E - Erythema Marginatum (redness in trunk)
  • S - Sydenham's chorea (St. Vitus Dance; worm-like movements of arms and fingers)
• Jones Minor Criteria for Rheumatic Heart Fever - mnemonic: FRAPP
• Rheumatic Heart Fever

  Jones Minor Criteria (FRAPP)

  • F - Fever, low-grade
  • R - Raised ESR, CRP
  • A - Arthralgia
  • P - Prolonged PR interval
  • P - Previous RF (ASO Titer - not specific for rheumatic fever but GABHS)