Rheumatic heart disease caused by untreated streptococcal infection can lead to congestive heart failure. An 8-year-old boy presented with shortness of breath, cough, fever, joint pain, and scrotal swelling. Examination found an enlarged heart, liver, increased jugular vein pressure, and leg swelling. Tests showed increased inflammation markers and echocardiogram demonstrated mitral regurgitation from rheumatic heart disease, causing NYHA class II heart failure. The patient was given oxygen, diuretics, antibiotics, steroids, and ACE inhibitors, and advised rest in bed. Early recognition and treatment of rheumatic fever symptoms can help prevent progression to heart failure.
Rheumatic heart disease caused by untreated streptococcal infection can lead to congestive heart failure. An 8-year-old boy presented with shortness of breath, cough, fever, joint pain, and scrotal swelling. Examination found an enlarged heart, liver, increased jugular vein pressure, and leg swelling. Tests showed increased inflammation markers and echocardiogram demonstrated mitral regurgitation from rheumatic heart disease, causing NYHA class II heart failure. The patient was given oxygen, diuretics, antibiotics, steroids, and ACE inhibitors, and advised rest in bed. Early recognition and treatment of rheumatic fever symptoms can help prevent progression to heart failure.
Rheumatic heart disease caused by untreated streptococcal infection can lead to congestive heart failure. An 8-year-old boy presented with shortness of breath, cough, fever, joint pain, and scrotal swelling. Examination found an enlarged heart, liver, increased jugular vein pressure, and leg swelling. Tests showed increased inflammation markers and echocardiogram demonstrated mitral regurgitation from rheumatic heart disease, causing NYHA class II heart failure. The patient was given oxygen, diuretics, antibiotics, steroids, and ACE inhibitors, and advised rest in bed. Early recognition and treatment of rheumatic fever symptoms can help prevent progression to heart failure.
COMPREHENSIVE MANAGEMENT OF RHEUMATIC HEART DISEASE WITH
NYHA II CONGESTIVE HEART FAILURE
Alyssa Fairudz Shiba*, Hanif Abdurahman Latief*, Andika Yusuf R*, Roro Rukmi** *Medical Faculty Lampung University ** Pediatric Department, Abdul Moeloek Hospital
Introduction:Heart failure is a condition in which heart is unable to pump enough blood
circulation in accordance to the needs of body. In children, one of the most common etiology of heart failure is rheumatic heart disease which is a sequele of rheumatic fever, an infection caused by Group A Streptococcus. Method: In this case, A 8 year old boy complained shortness of breathing when doing activities, productive cough, mild fever, joint pain and swelling in scrotum for the past 1 month before hospitalization. In physical examination we found heart rate (HR) 110 bpm, respiratory rate (RR) 32 bpm, increase of Jugular Venous Pressure ( JVP), pansystolic murmur with grade 4/6 and thrill, enlargement of heart border, enlargement of liver , and scrotal oedem with soft consistensy and not hyperemic . Laboratory showed increased Erythrocyte Sedimentation Rate (ESR), positive ASTO with quantitative CRP >12 mg/L; thoracic X-ray showed cardiomegaly ; ECG obtained a P-R interval lengthwise and echocardiography showed mitral regurgitation et causa RHD with mild tricuspid regurgitation. Patient was diagnosed with Rheumatic Heart Disease with NYHA II Congestive Heart Failure. Patient was bedrest and was given oxygenation, ACEI, diuretics, antibiotics, and steroids. Conclusion: The progessivity of RHD become CHF is depend on accuracy recognizing symptom in primary and secondary care.