Rheumatic fever

11. Acute rheumatic carditis
 Pericarditis
 Chest pain
 Pericardial friction rub
 Myocarditis
 Tachycardia
 Heart failure
 Endocarditis
 MV is involves with/without involvement of AV/TV
 New or changing murmur
MV IS ALWAY AFFECTED

12. Valvular involvement in chronic
rheumatic heart disease
 Mitral valve : 65-70%
 Aortic valve : 25%
 Tricuspid : 10%
 Pulmonary : rarely involved

16. Clinical features
•Occur in 5-10% of case
•Involuntary semi purpose movements of body
•Involving limb/trunk/head/neck
•May affect speech
•Movements disappear during sleep
Sydenham chorea

32. Other alternative drugs used
 Clarithromycin (in patient allergic to penicillin)
7.5mg/kg PO bid for 10 days
 Azithromycin (in patient allergic to penicillin)
12mg/kg (note to exceed 500mg) PO OD for 5days