Rheumatic heart disease

Rheumatic fever can lead to rheumatic heart disease. Rheumatic fever is an acute inflammatory disease that can happen along with acute pharyngitis caused by the Streptococcus group. One that is beta-hemolyticus In children and young adults all throughout the world, these recurrent illnesses are a leading cause of acquired heart disease.

Pathophysiology

Rheumatic heart illness develops when there is either an autoimmune reaction or an antigenic match between human tissue and somatic antigen streptococcus. Antibodies are rapidly produced in response to a Streptococcus group A beta-hemolytic infection because of the organism's ability to rapidly replicate in the human body. Myocardial sarcolemma is a target because antibodies against cardiac tissue are present in serum penderiat DR, and myocardial tissue is harmed because of this. Streptolysin titer 0, which is a product of extracellular Streptococcus group bacteria, is one toxin that may contribute to the development of DR. It is known that a beta-hemolytic is bad for myocardial tissue.

The numerous somatic streptococcal antigens can settle for varying amounts of time. Patients who have streptococcal sore have a higher than normal serum immunoglobulin level, especially after receiving Ig G and A.

Causes

• There is a history of rheumatic fever in the family
• Age: often occurs between the ages of 5-15 years and rarely at the age of fewer than 2 years.
• Social cause: Often occur in families with social and economic conditions less, bad housing with residents who crowded and humid air, and nutrition and ill health.
• Seasons can also cause this disease. In countries with 4 seasons, there is a high incidence in late winter and early spring (March-May) while the lowest incidence is in August-September.
• Previous rheumatic fever attack.
• Rheumatic heart disease after repeated attacks of reinfection with Streptococcus group A beta-hemolytic is often in children who previously had received rheumatic fever.

Sign and symptoms

• Feeling tired
• Pale
• Anorexia
• Tachycardia
• Dysrhythmias
• Noisy pathological
• More enlarged, heart failure
• Signs of pericarditis

Diagnosis

• Blood tests
• Bacteriological examination
• Serological examination
• Radiological examination

Treatment

• After rheumatic fever or acute rheumatic heart disease, preventative or prophylactic treatment is recommended to protect the heart's valves from future damage.
• Secondary prophylaxis begins with primary prophylaxis (the first round of antibiotics used to treat streptococcal illness) (prevention of recurrent rheumatic fever and rheumatic heart disease).
• For secondary prophylaxis, most doctors in the United States advise giving patients an intramuscular injection of 0.6-1.2 million units of benzathine penicillin G every 4 weeks. Patients in high-risk groups, those with persistent carditis, and those living near rheumatic fever hotspots should all get the same dosage every three weeks.

Nursing management

• Observation of vital signs: temperature, pulse, BP, breathing every 3 hours
• Give an explanation of the causes of fever or increased body temperature
• Give an explanation to the client and family about the things done
• Explain the importance of bed rest for the client and the consequences if it is not done
• Encourage clients to drink lots of approximately 2.5 to 3 liters/day and explain its benefits
• Encourage clients to eat in small portions and frequently, if not vomiting continue
• Perform good oral care after vomiting.
• Assess the factors that influence the patient's reaction to pain
• Provide a comfortable position, keep the situation quiet room
• Give a happy atmosphere for patients, so they can divert their attention from pain (involve family)
• Provide opportunities for clients to communicate with friends/people closest.
• Give appropriate analgesic drugs instructions To know how many levels of pain experienced
• Monitor cardiac complications.
• Monitor the existence of joint inflammation.
• Provide play therapy to a child as a diversion therapy.
• Create the schedule of activity and rest for a child.
• Providing oxygen therapy.
• Sleeping position 45 degrees semi-fowler.
• Provide education to the caretakers about the hygiene, diet, etc of the child.
• Provide medication according to the prescription and timely.
• Provide psychological/emotional support to the caretakers/parents and child.