Modifiable Factors: RHEUMATIC HEART DISEASE Non-Modifiable Factors:

 Unhygienic, crowded  Poverty

living condition  Children between the
 Untreated or ages of 5 - 15 years old.
Etiology:  Children who have
inadequately treated
streptococcal throat Streptococcal group a beta- frequent cases of strep
hemolytic bacterial infection throat infections.
infections
(strep throat, pharyngitis)

If not treated to kill strep. If treated with penicillin in 1st

or starting infection.
Activation of immune response

Streptococcus dead.
Release of inflammatory No Rheumatic fever and RHD
mediators causing pharyngitis

Delayed sequence of events

take place after 2-3 weeks

The microorganism grow slowly,

multiply and gain access to
joints and vascular system

The organism enters the heart

and lodge in the endocardium
Valve deformities

Formation of bacterial
vegetation in the endocardial Fusion of the commissures
layer of the heart

Development of complex lesions

Formation of fibrin deposits in in the commissures (opening of
the valve leaflets valves)