Cold rheumatism, also referred to as rheumatic heart disease, is a systemic immune event that occurs after throat infection by beta-hemolytic streptococcus bacteria. Due to this situation, which is more common in developing countries, approximately 250,000 young people die every year around the world.
What is Cardiac Rheumatism (Acute Rheumatic Fever)?
Cardiac rheumatism is an undesirable consequence of the development of acute rheumatic fever and can occur even years after this condition has been treated. In this disease, which is characterized by damage to the heart valves, chronic inflammation (inflammation) occurs in the heart tissues. The onset of inflammation is the abnormal response of the immune system to the throat infection caused by bacteria. If inflammatory heart rheumatism is not treated, it should be conscious as it may progress to heart failure. The mitral valve is generally found to be affected in 50-60% of cases.
What are the Symptoms of Cardiac Rheumatism (Acute Rheumatic Fever)?
The main condition that may indicate the development of cardiac rheumatism is a recent history of throat infection or acute rheumatic fever. Symptoms of acute rheumatic fever are quite diverse and usually occur within 1-6 weeks following throat infection.
There are many signs and symptoms among the symptoms of acute rheumatic fever:
- Fever,
- Edema of the joints, especially in the knees and wrists, edematous, tender, red-colored and quite painful
- Development of nodules or skin rash under the skin,
- Involuntary movements occur in the arm, leg or facial muscles Symptoms such as shortness of breath, chest pain and edema may also be added to the disease picture following the development of cardiac rheumatism in patients with acute rheumatic fever.
What Causes Cardiac Rheumatism (Acute Rheumatic Fever)?
The onset of cardiac rheumatism is the result of deformity on the valves after single or recurrent attacks of rheumatic fever. During the course of acute rheumatic fever, involvement of the heart membrane (pericarditis), valves and internal � Cardiac tissue involvement (endocarditis) or muscle layer involvement (myocarditis) may occur. Permanent damage may occur in cardiac leaks in individuals who develop endocarditis over time, and loss of function may develop due to narrowing or leaks in these structures. .
How is the Diagnosis of Cardiac Rheumatism (Acute Rheumatic Fever)?
In the diagnostic approach to cardiac rheumatism, physicians primarily resort to taking a medical history and physical examination. During the medical history taking, subjects such as whether individuals have developed acute rheumatic fever before and whether they have experienced a recent throat infection are examined. In the physical examination procedures, it is evaluated whether there is any abnormality in the heart sounds of the patients.
As a result of cardiac rheumatism, heart sounds called murmur can be detected in addition to normal heart sounds. Murmurs occur as a result of these structures leaking the pumped blood due to the valves being affected. In some individuals, apart from murmurs, sounds that occur as a result of rubbing the heart tissues against each other during heartbeat due to inflammatory processes may also be heard. Evaluation of cabin chambers and valves is provided by using sound waves. Similar to ultrasonography, the device that detects sound waves through the skin projects an image on the screen. Various signs of rheumatic heart disease can be detected in the images, such as fluid collection around the heart, enlargement of heart structures, valve abnormalities, or leakage currents in the valves.
Electrocardiography (ECG)
ECG test is a test that detects the electrical activity in the heart muscle. This examination, which is generally used to illuminate problems related to heart rhythm, can also detect damage to heart tissue in some people. In this test, small sensors that can detect electrical activity on the skin are used.
Cardiac Magnetic Resonance Imaging (Cardiac MRI)
Examination of the heart with magnetic resonance imaging provides a very detailed image.
In addition to these examinations, other radiological imaging methods such as lung x-ray can be used to detect heart enlargement in some people. Physicians can also apply to various blood tests besides imaging methods to detect inflammation and infection conditions in the body.
Is Heart Valve Rheumatism Completely Gone?
Currently, there is no treatment that can completely cure heart valve rheumatism. Physicians should follow patients diagnosed with rheumatic fever or cardiac rheumatism very closely, so that early intervention should be provided for the problems that may occur.
In individuals with rheumatic fever, it may be necessary to use antibiotics regularly to prevent the development of heart valve rheumatism. At the same time, anti-inflammatory drugs can be prescribed to control the inflammation that occurs during the course of this disease.
How to Treat Cardiac Rheumatism?
The treatment approach to cardiac rheumatism can be examined in two parts as “prevention treatment” and “long-term control treatment”. The basic preventive treatment approach includes treating throat infections caused by streptococcal-derived bacteria with antibiotic drugs. If people have already been diagnosed with acute rheumatic fever, drugs that reduce inflammation within the scope of keeping it under control are also applied. Cardiac rheumatism surgery, which is defined as “percutaneous mitral balloon valvuloplasty”, may come to the fore. In severe valvular disorders, the valve can be replaced or repaired by surgical intervention. With the development of heart failure, in addition to the existing treatment, various cardiologist such as ace inhibitor, diuretic or beta blockers Drugs may also be prescribed.
Bacterial endocarditis and valve rupture (rupture) may also develop in patients with acute rheumatic fever who have not been properly diagnosed and treated other than heart failure. In bacterial endocarditis, the tissue inside the heart is affected. Valve rupture, on the other hand, is a condition that requires immediate medical attention with applications such as repair or replacement.
What Should Those With Cardiac Rheumatism Pay Attention To?
In individuals with acute rheumatic fever, this situation can occur again after subsequent streptococcal throat infections. there is a risk of occurrence. For this reason, it may be necessary to use antibiotic drugs within the scope of prophylactic (preventive) treatment to prevent future attacks.
The main factor in the development of cardiac rheumatism is the intake of streptococcal bacteria into the body. Therefore, it is very important to comply with the hygiene rules for heart rheumatism as well as in the fight against microorganisms with the potential to cause disease.
Regular washing of hands, especially after coughing and sneezing or before meals, is among the basic hygiene practices that can be done. Risky individuals should also be more careful in crowded environments. Environments such as military facilities, kindergartens or schools are examples of areas that are considered risky in terms of contact with this bacterium.
It is very important for individuals with rheumatic heart disease to visit health institutions regularly and to have their cardiovascular system-related functions evaluated.
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