This lecture is about oral health, rheumatic fever and rheumatic heart disease.

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2. Memorial Sloan Kettering Cancer Center (NYC)
University Hospitals of Columbia University and
Cornell Medical College (NYC)
MD Anderson Cancer (Texas)
Beijing Cancer Hospital (China)
Chongqing Medical University (China)
Suining Central Hospital (China)
De La Salle University – BS. Biology;
Medicine
Manila Med – General Surgery
SLMC – Surgical Oncology
Ateneo GSB - MBA
Prof. Roel Tolentino, MD, MBA
Further studies:

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Group A
Streptococcus

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14. CLINICAL FEATURES

15. STREPTOCOCCUS SORE THROAT

16. Clinical features of RF
• Streptococcal sore throat with
fever
• Shortness of breath

17. CAUSES
Everyday oral activities:
• brushing your teeth
• chewing food

18. CAUSES
An infection or other medical condition.:
• infected area, such as a skin sore
• gum disease
• sexually transmitted infection

19. CAUSES
• Weakened immune system
• Certain dental procedures

20. WHAT IS
RHEUMATIC FEVER ?

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22. • Age: 5-30 years
• Untreated streptococcal infection
• Familial predisposition
RISK FACTOR

23. • Over crowding
• Poverty , Poor hygiene
• Lack of access to medical care
RISK FACTOR

24. LAB DIAGNOSIS

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28. Nodules -Firm, non-tender, isolated or
in clusters

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30. ERYTHEMA
MARGINATUM

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33. EPIDEMIOLOGY
• RF and RHD is the most common cause of heart
disease in 5-30 age groups throughout the world.

34. EPIDEMIOLOGY
• It accounts for 12-65% of hospital admissions related
to CVD in developingcountries.

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38. Rheumatic heart
disease (RHD)
• most common acquired heart disease in children,
especially in developing countries.
• caused by rheumatic fever that can be prevented
and controlled.

39. • Congestive heart failure
• Infective endocarditis
• Arrhythmias mainly atrial fibrillation
COMPLICATIONS

40. • Embolic episodes
• Cardiomegaly
COMPLICATIONS

41. Normal valve is
Transparent,
avascular, thin
flexible membrane.
RHD: Thick, fibrous
scarred stenotic &
fixed (MS/MR) with
Blood Vessels.
THE DIFFERENCE

42. VALVE INVOLVEMENT IN RHD

43. MITRAL STENOSIS

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47. PRIMARY PREVENTION
Detection and management of streptococcal
throat infection.

48. PRIMARY PREVENTION
Promote health :
improve living conditions
hygiene, avoid over crowding
access to medical facilities
education

49. Supportive Management
• Bed rest
• Treatment of congestive cardiac failure
• Treatment of chorea

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51. KEY MESSAGE

52. roel_tolentino@yahoo.com
788-1412
0916-4079417
0932-8462203
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