1. Rheumatic Heart Disease/ Infective Endocarditis
Crystal Reider, Alysia Silva, and Carrie Oubre

2. What is Rheumatic Heart Disease
Rheumatic heart disease (RHD) is the most common acquired heart disease.
It presents as damage to the heart valves.

3. Rheumatic Heart Disease
Etiology: Complication following Rheumatic Fever.
Cause of Rheumatic fever: Infection called Streptococcal bacteria.
Occurrence: Typically in children and young adults in countries with a low income.
Treatment: Antibiotic therapy, aspirin, steroids, and NSAIDS. Surgery may be needed to repair or replace the damaged heart valves.

4. Rheumatic Heart Disease
Indications: Antibiotic Prophylaxis for any dental treatment performed. Also a doctor’s release to determine the extent of the heart valve damage before treatment.
Contraindications: Patient’s that have RHD who show signs of congestive failure should see a physician before treatment.
Oral effects: Pharyngitis, oral temperature between 101 and 102.
Effects of medications: Candidiasis and gingival bleeding.

5. Rheumatic Heart Disease
Periodontal Management: Good oral hygiene, fluoride, chlorhexidine rinses, routine prophylaxis cleanings.
DH Considerations: Premed before treatment and maintenance of a high level of oral health to prevent periodontal disease or caries.

6. Infective Endocarditis
Microbial infection of the heart valves or endocardium.
Etiology: Almost any microorganism; streptococci and staphylococci are the most responsible.
Prevention: Good oral hygiene, antibiotic premed before any dental or medical procedures, consult with physician.

7. Relation of Infective endocarditis to rheumatic heart disease
Rheumatic Heart Disease requires premedication before dental treatment to prevent contracting infective endocarditis.
The damaged heart valve is susceptible to infective endocarditis.

8. Review
1. Which of the following bacteria cause infective endocarditis?
Bartonella
Streptococci & staphylococci
Treponema pallidum
Porphyromonas gingivalis

9. 2. All of the following medications are used to treat rheumatic heart disease except:
NSAIDs
Antibiotic therapy
Steroids
Antiemetics

10. 3. Rheumatic heart disease is the most common acquired heart disease
3. Rheumatic heart disease is the most common acquired heart disease. Rheumatic heart disease always progresses to infective endocarditis.
Both statements are true.
Both statements are false.
1st statement is true, 2nd is false.
1st statement is false, 2nd is true.