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Rheumatic Heart Disease
Rheumatic Heart Disease
Definition
Rheumatic fever is systemic inflammatory disease
caused by immune response to pharyngeal
infection by group A beta-hemolytic streptococci
Client with Rheumatic Fever
and Rheumatic Heart Disease Rheumatic fever is self-limiting disorder usually
occurring between 5 – 15 years of age
Immune response results in inflammation in Usually affects valves on left side of heart
connective tissues on heart, joints, and skin
especially mitral valve
a. Carditis: in all layers of heart tissue in 50%
Stenosis of valve: narrowed fused valve
persons with rheumatic fever
obstructs forward blood flow
b. Endocardial inflammation results in fibrous
scarring of valve leaflets causing deformity Regurgitation occurs with incompetent valve
(fails to close properly) and allows blood to
flow back through
1
10/4/2017
Collaborative Care
Throat culture:
positive for group A beta-hemolytic 1. Eradicating the streptococcal infection
streptococcus in 25– 40% of clients 2. Managing manifestations of disease
with acute rheumatic fever
3. Limiting activities, generally
2
10/4/2017
Activity Intolerance
Home Care
1. Activities are limited during acute phase of
carditis to reduce workload of heart Most clients recuperate at home and need teaching
for acute care and prevention of recurrences
2. Gradual activity progression encouraged as Client must complete full course of antibiotic therapy
condition improves and continue antibiotic prophylaxis
3. Allow visits from friends/ family. Diversional Recognition of streptococcal sore throat and early
activities (reading, listening, playing card, manifestations of heart failure and seek medical
attention
watching)
Follow prescribed activity and diet (usually high
carbohydrate, high protein with possible sodium
restriction)