MATERNAL - RF and RHF

Rheumatic Fever (RF)

Inflammatory disease occurs after Group A Beta-haemolytic streptococcal throat infection

Rheumatic Fever (RF)

Self-limiting

Rheumatic Fever (RF)

Risk factors: 5-15 Female, Housing and socioeconomic

status, Rainy season, Genetic predisposition

Rheumatic Fever (RF)

Acute febrile-like illness (2-3 weeks after streptococcal throat infection)

Joints

(swelling and pain of larger joints like knee, ankle,

elbow and wrist occurring in rapid succession - "migratory

arthritis")

Heart

(causes inflammation of the whole layers of the heart -

PANCARDITIS) - Palpitation, chest pain, shortness of breathe,

leg swelling, etc.

Skin & subcutaneous tissues

(non-itching macular rash and painless mobile nodules over joints and spines)

Central Nervous System

(a late manifestation) - abnormal movements of the limbs with muscle weakness and emotional labiality.

Modified Jones Criteria

2 major or 1 major + 2 minor manifestations + strep infection

Major

Carditis, Polyarthritis, Erythma marginatum - rash, Subcutaneous nodules, and St. Vitus Dance

St. Vitus Dance

The Fifth Manifestation (Sydenham's Chorea)

St. Vitus Dance

also known as chorea and reflects CNS involvement

Chorea

refers to sudden, aimless movements of extremities, involuntary facial grimaces, speech disturbances, emotional lability and muscle weakness

Minor

Arthralgia, Fever, elevated esr and crp and prolonged pr interval in ecg.

Salicylates (ASA)

control inflammatory process esp. joints, dec fever and discomfort

Rheumatic Heart Disease (RHD)

Most common complication of RF

Permanent

There is no cure for rheumatic heart disease and the damage to the heart valves are?

Rheumatic Heart Disease (RHD)

Damage to valves leading to stenosis or regurgitation with resultant hemodynamic disturbance.

Kawasaki disease

causes swelling (inflammation) in children in the walls of small to medium-sized blood vessels that carry blood throughout the body.

Kawasaki disease

Self limiting but 20% children without treatment develop cardiac disease

C

Conjunctivitis (pink eye)

R

rash

A

Arthritis

S

Strawberry tongue

H

Hands (peeling skin)

Irritability

hallmark of Kawasaki Disease

Myocardial Infarction

is the principal cause of death in patients with Kawasaki disease.

Conjunctival injection

is a common condition that refers to the inflammation and dilation of blood vessels of the eye that supply the conjunctiva.

Kawasaki disease

treatment: high-dose IVIG along with salicylate therapy.

high-dose IVIG

has been shown to reduce the duration of fever and the incidence of coronary artery abnormalities when given within the first 10 days of illness and optimally within the first 7 days

Aspirin

is given initially in an anti-inflammatory dosage to control fever and symptoms of inflammation.

Cardiac tamponade

Compression of heart by blood and other effusion

(clots) in pericardial sac → restricts normal heart

movement

Pericardiocentesis

is a procedure performed to remove pericardial fluid from the pericardial sac.

Ejection fraction (EF)

Is a measurement, expressed as a percentage, of how much blood the left ventricle pumps out with each contraction. Normal EF is >50% to 70%.

2D Echo

Enables visualization and measurements of turbulence,

accentuation, direction, and decreases/ increases in blood

flow, along with pressure gradients

2D Echo

Uses high-frequency sound waves obtained by a transducer to produce an image of cardiac structure

Angiography

Assess route of blood flow in heart & major blood vessels

ABG

Helpful in differentiating between cardiac and pulmonary

pathologies

ABG

arterial blood gas

ABG

Important when the child is at risk or complications such as

acidosis and shock

Cardiac catheterization

is a procedure used to show on a computer monitor diseases that affect the heart, the cardiac valves or the coronary arteries.

Cardiac catheter

is a thin, flexible plastic tube that is moved through a blood vessel until it reaches the heart. X-ray monitoring is used to guide the catheter.

Left heart catheterization (arterial catheter)

This catheter is advanced through an artery in your groin region, elbow or wrist and into the heart's left ventricle.

Right heart catheterization (venous or flow-directed catheter)

The catheter is inserted through a vein in the groin region or at the elbow and then advanced to the right ventricle and the pulmonary artery.

Angiography

is a procedure that allows doctors to look at blood vessels in great detail using X-rays.

Angioplasty

If the doctors identify a narrowed portion (stenosis) of a blood vessel during the angiography procedure, they may stretch or widen it straightaway using a procedure called?

Angioplasty

means using a balloon to stretch open a narrowed or blocked artery.

Stent

most modern angioplasty procedures also involve inserting a short wire mesh tube, called a?

Stent

is left in place permanently to allow blood to flow more freely.

Open-heart surgery

is any type of surgery where the chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart.

Cardiopulmonary bypass (CPB)

provides a bloodless field for cardiac surgery.

Cardiopulmonary bypass (CPB)

It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump.