AM Report March 5, 2010 Amy Auerbach

Slides:



Advertisements
Similar presentations
Rheumatic Fever and Rheumatic Heart Disease
Advertisements

Diagnosis of ARF in children
Rheumatic Valvular Heart Disease Acute Rheumatic fever (RF) & Chronic rheumatic heart disease (RHD) Doç. Dr. Işın DOĞAN EKİCİ Department of Pathology.
REVISED JONES CRITERIA WHO Criteria for the Diagnosis of RF and RHD
ACQUIRED HEART DISEASES
Rheumatic Fever AND RHD
©2007 World Heart Federation … Updated October 2008 Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease.
ACUTE RHEUMATIC FEVER. Definition Current Diagnosis 07 An acute systemic immune disease that may develop after an infection with Group A beta- hemolytic.
Rheumatic Fever Rheumatic Fever. 05/05/1999Dr.Said Alavi2 Etiology Acute rheumatic fever is a systemic disease of childhood,often recurrent that follows.
Rheumatic fever Group a steptococcal URTI. AGE PEAK AGE YRS IN INDIA UPTO 45 YRS MANIFESTATIONS -2 ND -3 RD –DECADE OF LIFE.
Acute Rheumatic Fever and Heart Disease Howard Sacher, D.O. Long Island Cardiology and Internal Medicine.
Department faculty and hospital therapy of medical faculty and department internal diseases of medical prophylactic faculty. Acute rheumatic fever.
R HEUMATIC F EVER. Collagen vascular disease with inflammation involving many organs mainly heart, brain, joints and skin. The acute form of the disease.
By Dr. Saud A. Bahaidarah Pediatric cardiologist.
By:Dawit Ayele. Definition  Rheumatic fever is an inflammatory disease that occurs as a delayed, non-suppurative sequela of upper respiratory infection.
Acute rheumatic fever (ARF) is a delayed, nonsuppurative sequela of a pharyngeal infection with the group A streptococcus.
Assessment of CVS & Murmurs
Rheumatic fever Rheumatic fever is an inflammatory disease which may develop after a Group A Streptococcal infection (such as strep throat or scarlet fever)
Rheumatic Fever. Normal Heart Anatomy Rheumatic Fever (RF) Definition: Rheumatic fever (RF) is an autoimmune disease affecting the heart and extra- cardiac.
Mana Kidz Rheumatic Fever Prevention:
RHEUMATIC HEART DISEASE
 results in stenosis or insufficiency (regurgitation or incompetence), or both.  Stenosis : failure of a valve to open completely, obstructing forward.
Definition: Acute, immunologically mediated multisystemic inflammatory disease following group A streptococcal pharyngitis.affecting joints, skin, heart.
VALVULAR HEART DISEASE
RHEUMATIC FEVER Rheumatology Research Center. Definition A multisystem disease resulting from an autoimmune reaction to infection with group A streptococci.
Case Presentation 연세의대 강남세브란스병원 박 희 완 김 O 균 M/14y9m C.C. : Intermittent left hip painC.C. : Intermittent left hip pain D. : 2 wksD. : 2 wks PE.
Rheumatic Heart Disease
RHEUMATIC HEART DISEASE D. HANA OMER. OBJECTIVES To know definition, symptoms, signs, diagnosis of Rheumatic fever. To know the treatment of Rheumatic.
Dr.aso faeq salih.  Autoimmune consequence of infection with Group A streptococcal infection  Results in a generalised inflammatory response affecting.
..  Rheumatic fever (RF) is an acute, immunologically mediated, multisystem inflammatory disease that occurs a few weeks following an episode of group.
Prof. Pavlyshyn H.A. ACUTE RHEUMATIC FEVER. DEFINITION Rheumatic fever is an inflammatory process which can involve the joints, heart, skin and brain.
Rheumatic Fever. Rheumatic fever is an inflammatory disease that may develop after an infection with Streptococcus bacteria (such as strep throat or scarlet.
Rheumatic heart disease CVS 4 Hisham Alkhalidi. Rheumatic fever (RF) Acute Immunologically mediated Multisystem inflammatory disease Occurs few weeks.
RHEUMATIC FEVER PROF.DR. AYÇA VİTRİNEL. A postinfectious, immune-mediated, inflammatory reaction that affects the connective tissue of multiple organ.
Prof.Dr.Selma KARABEY.  Rheumatic fever is a common cause of acquired heart disease in children and adolescents living in poor socioeconomic conditions.
Rheumatic fever By Dr. Ali Abdel-Wahab.
1 Rheumatic Fever. 2 ObjectivesObjectives Etiology Epidemiology Pathogenesis Pathologic lesions Clinical manifestations & Laboratory findings Diagnosis.
Valvular Heart Disease. Valves Mitral valve Aortic valve Tricuspid valve Pulmonary valve.
Questions, Answers, and Explanations Infectious Diseases Blueprint.
Rheumatic fever, cardiac complications and how to prevent them Rüdiger Schultz MD, PhD Pediatrician Ilembula Hospital.
ACUTE RHEUMATIC FEVER.  Multisystem disorder typicaly follows an episode f strep.pharyngitis(2-3 weeks) and usually presents with fever,anorexia,lethargy.
Rheumatic Fever Dr.M.H.Jokar
Rheumatic Heart Disease Department of Pathology
VALVULAR HEART DISEASE results in stenosis or insufficiency (regurgitation or incompetence), or both. Stenosis : failure of a valve to open completely,
Rheumatic Fever Dr.Emamzadegan Pediatric Cardiologist.
Acute Rheumatic Fever Dr. Toba kazemi, MD Harrison
Acute Rheumatic Fever: Diagnostic and Management
Dr. J. Satish Kumar, MD, Department of Basic & Medical Sciences, AUST General Medicine Cardiology Name:_________________________________________ Rheumatic.
Rheumatic Heart Disease Rheumatic fever (RF) and rheumatic heart disease (RHD) cannot be separated from an epidemiological point of view. Rheumatic fever:
ACUTE RHEUMATIC FEVER.
Acute Rheumatic Fever – The Basics Dr Peter Murray Public Health Registrar May 24, 2016.
Acute Rheumatic Fever Prof . El Sayed Abdel Fattah Eid
EPIDEMIOLOGY OF REUMATIC FEVER
Rheumatic Fever & Rheumatic Heart Disease in New Zealand
Rheumatic Heart Disease
RHEUMATIC HEART DISEASE
Acute Rheumatic Fever (ARF)
Rheumatic Heart Disease Department of Pathology
Diagnosis & management Acute rheumatic fever
Acute Rheumatic Fever.
Rheumatic Heart Disease Department of Pathology
12. RHEUMATIC HEART DISEASES
Rheumatic Heart Disease Department of Pathology
CARDITIS RHEUMATIC HEART DISEASE and CLINICAL ASPEC
Rheumatic heart disease
Rheumatic fever by mbbsppt.com.
"Rheumatic Fever" Ahmed Salam Lectures Medical Student “TSU”
Classically migratory, transient, asymmetric polyarthritis Large to mid peripheral joints – knees, ankles (talar and subtalar), wrists, elbows,
Rheumatic Heart Disease Department of Pathology
Presentation transcript:

AM Report March 5, 2010 Amy Auerbach Acute Rheumatic Fever AM Report March 5, 2010 Amy Auerbach

Predisposing Factors Typically preceded by group A streptococcal tonsillopharyngitis (two to four weeks prior to ARF) ? Whether GAS skin infections could also predispose Most frequent in children between 4 and 9 years of age

Clinical Manifestations Migratory arthritis (involving large joints) Carditis and valvulitis Central nervous system involvement (Sydenham chorea) Rash

Arthritis Typically migratory arthritis- knees, ankles, elbows, wrists most commonly Often earliest manifestation May see monoarticular arthritis if patient has received salicylates or other NSAIDs Joint analysis demonstrates steril inflammatory fluid Minimal changes in serum levels of complement

Carditis Pancarditis affecting the pericardium, epicardium, myocardium, and endocardium Symptoms may be subtle or non-existent May see mitral regurgitation early on Mitral stenosis is manifestation of late scarring and calcification Echocardiography always indicated to assess for valvular disease

Chorea Sydenham chorea- abrupt, purposeless, nonrhythmic involuntary movements, muscular weakness, emotional disturbances Commonly more marked on one side and cease during sleep Emotional disturbances typically manifest as inappropriate behavior, crying, restlessness Can see diffuse hypotonia Often has longer latent period than other manifestations

Subcutaneous Nodules Firm and painless, typically a few milliliters to one to two centimeters Typically located over bony surface or near tendon Present for 1-2 weeks but rarely more than a month Least common manifestation (in the US)

Erythema marginatum Typically occurs early in the disease May persist or recur even when all other manifestations have disappeared Typically occurs only in patients with carditis

Jones Criteria High probability of ARF if the following criteria are met: Evidence of preceding group A streptococcal infection Two major manifestations OR One major and two minor manifestations

Major Manifestations Carditis Polyarthritis Chorea Erythema marginatum Subcutaneous nodules

Minor Manifestations Arthralgia Fever Elevated ESR or CRP Prolonged PR interval

Other Factors Three settings in which diagnosis can be made without Jones Criteria Chorea as only manifestation Indolent carditis months after acute infection Recurrent rheumatic fever in patients with history of rheumatic fever or rheumatic heart disease

Therapy Symptomatic relief Eradication of GAS Prophylaxis against future GAS infection to prevent recurrent disease Primary prevention most important: prompt diagnosis and treatment of group A streptococcal tonsillopharyngitis

Take Home Points Polyarthritis is typically the first manifestation but may present weeks after GAS tonsillopharyngitis Patients already treated with aspirin and NSAIDs may not meet criteria for ARF despite having the disorder Carditis is most severe manifestation and can be prevented by prompt treatment of GAS