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RHUEMATIC HEART
    DISEASE
DEFINITION
• Rheumatic heart disease is a chronic
  condition resulting from rheumatic
  fever that is characterized by
  scarring and deformity of the heart
  valves
ETIOLOGY
• Acute rheumatic fever
• Cardiac lesions and valvular
  deformities
• Extra cardiac lesions
PATHOPHYSIOLOGY
Rheumatic fever+ recurrent infection
       rheumatic pancarditis
        Endocarditis in valves
       erosion of valve leaflets
        fibrous thickening
         thickened valves
   stenosis and regurgitation
ASCHOFF’S BODIES
• Histologic nodules formed by
  reaction to inflammation with
  swelling and fragmentation of
  collagen fibres
CLINICAL
      MANIFESTATION
•    MAJOR CRITERIA
•    - carditis
•    -polyarthritis
•    -chorea
    -erythema marginatum
•   MINOR CRITERIA
•   -fever ,polyarthritis
•   -inc. ESR, inc.WBC
•   -CRP
Daignostic Evaluation
• Echocardiogram
• Chest X-Ray
• ECG-prolonged PRinterval,delayed AV
  conduction
MANAGEMENT
• MEDICAL MANAGEMENT
• NURSING MANAGEMENT
•    -subjective assesment
•    -objective assesment
Nursing Daignosis

• Activity intolorence related to
  arthralgia secondry to joint pain
• Decreased cardiac output related to
  valve dysfuntion,HF
• Ineffective therapuetic regimen
  related to lack of knowledge
• HEALTH PROMOTION
• ACUTE INTERVENTION
• AMBULATORY AND HOME CARE
THANK YOU

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