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Rheumatic Heart Disease
Presented by:Chikku. S
Assistant Professor
St.Thomas College Of Nursing,kattanam
Definition
It is an inflammatory disorder of heart involving all the
layers and which is characterised by scarring and
deformities of heart valves
INCIDENCE
● It is estimated that there are over 15 million cases of RHD
world wide.
Etiology
● Group A Streptococcal infection
Pathophysiology
Etiological factors leads to production of antibodies against antigen
Inflammation of myocardium, endocardium and pericardium
Valvular heart disease- valve prolapse, valvular stenosis, occurs
both tricuspid and bicuspid valves
Valvular regurgitation occurs
● Increased in the blood volume with in the atrium
● Atrial dilatation associated with increased pressure
● Pressure transmit to ventricles caused ventricular dilatation and
hypertrophy
● Systemic hypertension and pulmonary hypertension
● Heart failure
Clinical features
● Johns Criteria
● Major criteria
⚪ Carditis
⚪ Erythemamarginatum
⚪ Subcutaneous nodules
⚪ Poly arthritis
⚪ Chorea
⚪ Aschoff bodies
● Minor criteria
⚪ High grade fever
⚪ Raised ESR level
⚪ Arthralgia
⚪ 1o
AV block
⚪ Previous history of RF
⚪ Fatigue
⚪ Anorexia
⚪ Insomnia
Diagnostic features
● Blood test
⚪ RA Factor
⚪ ESR
⚪ CRP
⚪ CBC
● Chest X ray
● ECG- LVH, 1o
AV block, Atrial Dilatation
● Echo- EF, pericardial thickening
● Other
⚪ Throat swab culture
⚪ CT Scan
⚪ ASO Titre
⚪ MRI Scan
Complications
● Mitral stenosis
● Heart failure
● LVH
● Pericardial thickening
● Valvular dysfunction
● Pancarditis
● Cardiomegaly
● Pulmonary edema
Management
● Medical management
⚪ Antibiotic therapy
⚪ Anti inflammatory medications
⚪ Cardiac glycosides
⚪ ACE inhibitors
⚪ Antiplatelets
Surgical management
● Balloon valvuloplasty
● Heart transplantation
● Mitral sternotomy
● Valve repair
● Valve replacement
NURSING MANAGEMENT
● Promotion of optimal bed rest.
● Nurse should administer antibiotic inorder to treat
streptococal infection.
● Teach about importance of antibiotic therapy.
● Administer NSAIDs.
● Painful joint should be positioned for comfort and proper
alignment.
● Patient without carditis should ambulate.

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Rheumatic heart disease Nursing.ppt

  • 1. Rheumatic Heart Disease Presented by:Chikku. S Assistant Professor St.Thomas College Of Nursing,kattanam
  • 2. Definition It is an inflammatory disorder of heart involving all the layers and which is characterised by scarring and deformities of heart valves
  • 3. INCIDENCE ● It is estimated that there are over 15 million cases of RHD world wide.
  • 4. Etiology ● Group A Streptococcal infection
  • 5. Pathophysiology Etiological factors leads to production of antibodies against antigen Inflammation of myocardium, endocardium and pericardium Valvular heart disease- valve prolapse, valvular stenosis, occurs both tricuspid and bicuspid valves Valvular regurgitation occurs
  • 6. ● Increased in the blood volume with in the atrium ● Atrial dilatation associated with increased pressure ● Pressure transmit to ventricles caused ventricular dilatation and hypertrophy ● Systemic hypertension and pulmonary hypertension ● Heart failure
  • 7.
  • 8. Clinical features ● Johns Criteria ● Major criteria ⚪ Carditis ⚪ Erythemamarginatum ⚪ Subcutaneous nodules ⚪ Poly arthritis ⚪ Chorea ⚪ Aschoff bodies
  • 9. ● Minor criteria ⚪ High grade fever ⚪ Raised ESR level ⚪ Arthralgia ⚪ 1o AV block ⚪ Previous history of RF ⚪ Fatigue ⚪ Anorexia ⚪ Insomnia
  • 10.
  • 11.
  • 12.
  • 13. Diagnostic features ● Blood test ⚪ RA Factor ⚪ ESR ⚪ CRP ⚪ CBC ● Chest X ray ● ECG- LVH, 1o AV block, Atrial Dilatation ● Echo- EF, pericardial thickening
  • 14.
  • 15.
  • 16. ● Other ⚪ Throat swab culture ⚪ CT Scan ⚪ ASO Titre ⚪ MRI Scan
  • 17. Complications ● Mitral stenosis ● Heart failure ● LVH ● Pericardial thickening ● Valvular dysfunction ● Pancarditis ● Cardiomegaly ● Pulmonary edema
  • 18. Management ● Medical management ⚪ Antibiotic therapy ⚪ Anti inflammatory medications ⚪ Cardiac glycosides ⚪ ACE inhibitors ⚪ Antiplatelets
  • 19. Surgical management ● Balloon valvuloplasty ● Heart transplantation ● Mitral sternotomy ● Valve repair ● Valve replacement
  • 20. NURSING MANAGEMENT ● Promotion of optimal bed rest. ● Nurse should administer antibiotic inorder to treat streptococal infection. ● Teach about importance of antibiotic therapy. ● Administer NSAIDs. ● Painful joint should be positioned for comfort and proper alignment. ● Patient without carditis should ambulate.