3. What is Rheumatic Heart Disease?
⦿ Rheumatic heart disease starts as a sore throat from a bacterium called
Streptococcus pyogenes (group A streptococcus) which can pass easily
from person to person in the same way as other upper respiratory tract
infections. Strep infections are most common in childhood.
⦿ In some people, repeated strep infections cause the immune system to
react against the tissues of the body including inflaming and scarring the
heart valves. This is what is referred to as rheumatic fever. Rheumatic
heart disease results then from the inflammation and scarring of heart
valves caused by rheumatic fever.
4. What causes RHD?
⦿ Rheumatic heart disease is caused by rheumatic fever, an inflammatory
disease that can affect many connective tissues, especially in the heart,
joints, skin, or brain. The heart valves can be inflamed and become
scarred over time. This can result in narrowing or leaking of the heart
valve making it harder for the heart to function normally. This may take
years to develop and can result in heart failure.
5. Who is at risk of RHD?
⦿ Untreated or under-treated strep infections can
increase the risk for rheumatic heart disease. Children
who get repeated strep throat infections are at the
most risk for rheumatic fever and rheumatic heart
disease.
⦿ Rheumatic fever can occur at any age, but usually
occurs in children ages 5 to 15 years old.
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6. Symptoms of RHD
The most common symptoms of Rheumatic Heart Disease are:
⦿ Fever
⦿ Swollen, tender, red and extremely painful joints — particularly the
knees and ankles
⦿ Nodules (lumps under the skin)
⦿ Red, raised, lattice-like rash, usually on the chest, back, and abdomen
⦿ Shortness of breath and chest discomfort
⦿ Uncontrolled movements of arms, legs, or facial muscles
⦿ Weakness
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7. CONT’D
Symptoms of rheumatic heart disease depend on the
degree of valve damage and may include:
⦿ Shortness of breath (especially with activity or when
lying down)
⦿ Chest pain
⦿ Swelling
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8. What are the complications of
rheumatic heart disease?
Some complications of rheumatic heart disease include:
⦿ Heart failure. This can occur from either a severely narrowed or leaking
heart valve.
⦿ Bacterial endocarditis. This is an infection of the inner lining of the heart,
and may occur when rheumatic fever has damaged the heart valves.
⦿ Ruptured heart valve. This is a medical emergency that must be treated
with surgery to replace or repair the heart valve.
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10. ⦿ Do more listening than talking.
⦿ Ask open-ended questions, not just questions clients can answer with “yes” or
“no.”
⦿ Repeat what clients say to make sure you understood them correctly.
⦿ Show interest in and empathy for clients’ problems and situations.
⦿ Avoid judging clients.
⦿ Listen to what clients think and respect their feelings, even if information may
need correction.
⦿ Recognize and praise what clients are doing correctly.
⦿ Suggest actions that are possible for clients given their situations.
⦿ Give only a little bit of information at a time.
⦿ Use simple language.
⦿ Give suggestions, not commands 10
11. Advices to the YOUNG ADULT
WITH RHEUMATIC HEART
DISEASE
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12. 1.Advise the patient to maintain good
nutrition.
⦿ Nutrition counseling aims to help clients understand important
information about their health and focuses on practical actions to
address nutrition needs, as well as the benefits of behavior
change.
⦿ Convince the patient to follow the diet plan given by the dietitan
or doctor. Advise the patient to consume more fruits, vegetables,
and other high-fiber foods. Include foods rich in omega 3 fatty
acids to fight inflammation,for example fatty fish like salmon,
mackerel, tuna and sardines.
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13. ⦿ Advise the patient to avoid tobacco, alcohol, chocolate,
sugar, butter, red meat, fats (particularly animal fats
and hydrogenated oils), fried foods, processed and
refined foods, soft drinks, spicy foods etc.
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14. 2.Advise the patient on hygienic
practices.
⦿ Good personal hygiene is one of the most effective ways to protect
ourselves and others from many illnesses.
⦿ Discuss proper disposal of tissues,laundering of handkerchiefs (decrease
risk of exposure to microbes).
⦿ Advise on washing hands regularly, especially before preparing or eating
food and after going to the toilet ,after handling dogs or other animals or
if they have been around someone who is coughing or has a cold.
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15. 3.Discuss importance of using patient’s own
toothbrush,soap,and washcloths when living in
group situations.
⦿ Advise patients that using their own toothbrush,soap,towels
etc,significantly reduces the risk of transmission of contagious
infections and viruses.
⦿ Nearly anytime you share anything with someone, you open
yourself to sharing viruses.
⦿ This is especially true for something like a toothbrush that may
be harboring virus-infected saliva. At the very least, if the person
has a cold or flu, you can catch it too if you use their toothbrush.
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16. 4.Advise patient on importance of receiving
adequate rest
⦿ Advise the patients that sleep/rest is an important
modulator of heart function and can thus lead to lower
activity and cardiac load.
⦿ Sleep lowers the blood pressure therefore not taking
rest can make the blood pressure stay high for longer
period of time which is a risk for heart disease.
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17. 5.Instruct patient to seek treatment
immediately should sore throat occur
⦿ Immediate treatment for sore throat is important as it
can cause complications such as ear infections,kidney
problems and rheumatic fever.
⦿ Advise the parents to take the patient to the doctor if
he or she has sore throat.
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18. 6.Support patients in long-term antibiotic
therapy to prevent relapse (5 years for most
adults).
⦿ motivate patient by discussing the benefits of
medication.
⦿ Also advice them to take their medicine on time,
suggest them to use a medication planner.
⦿ Encourage family memebers or parents to help with
these strategies.
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19. Conclusion
⦿ RHD is the most common heart-related disease in
developing countries and regions with a poor
population, mainly affecting children. Although RHD is
associated with high fatalities, it is a disease that can
be prevented, especially through screening that allows
for early treatment.
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20. Reference
⦿ Betterhealth.vic.gov.au. n.d. Rheumatic heart disease - Better Health
Channel. [online] Available at:
<https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/
rheumatic-heart-disease> [Accessed 16 September 2022].
⦿ Fantaproject.org. 2016. Nutrition Education and Counseling. [online]
Available at:
<https://www.fantaproject.org/sites/default/files/resources/NACS-
Module-3-Counseling-May2016.pdf> [Accessed 16 September 2022].
⦿ Who.int. 2020. Rheumatic Heart Disease. [online] Available at:
<https://www.who.int/news-room/fact-sheets/detail/rheumatic-
heart-disease> [Accessed 16 September 2022].
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