Traumatic Heart Disease Essay

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What is Rheumatic Heart Disease? Explain its cardiac involvement. Introduction: Although almost eradicated from developed communities, Rheumatic Heart Disease remains the main cause of heart failure in children in developing countries. Causing between 200,000 and 250,000 premature deaths each year 80-85% of children younger than 15 (approximately 2 billion) live in areas where rheumatic heart disease is endemic (2008 Population Reference Bureau). Rheumatic Heart Disease arises after an inappropriate immune response to an infection by Group A Streptococcal bacteria, causing valvular damage in the heart. It is most prevalent in children aged between 5 and 14 years, living in poverty and developing nations. Below I will outline and explain the pathophysiology, clinical presentation, epidemiology and cardiac involvement of Rheumatic Heart Disease. Pathophysiology: Rheumatic Heart Disease emerges approximately four weeks after the original infection in roughly 50% of cases of acute Rheumatic Fever. Although symptoms may appear much later, humoral and cellular immune responses occur after contact with Streptococcus pyogenes (Group A streptococcus), most commonly after Pharyngitis. There are several strains that are more likely to cause Acute Rheumatic Fever (which in turn can lead to Rheumatic Heart Disease), most notably S pyogenes, which have M, T and R surface proteins to aid attachment of the bacteria to the throats epithelial cells. The body produces autoimmune reactions, due to Group A Strep.’s imitation of antigens, causing widespread inflammation in the body. This includes granuloma in the myocardium (muscle tissue of the heart), also known as Pancarditis (inflammation of the entire heart). A granuloma is a collection of... ... middle of paper ... ...s. Joint inflammation is also very common, particularly polyarthritis (arthritic symptoms in several joints). This polyarthritis tends to migrate along the body and affects larger joints such as the knees, hips and elbows. Polyarthritis is considered a major diagnostic criterion. Moderate joint pain, which is more common, is a minor diagnostic criterion when evaluating Jones’ criteria for diagnosing rheumatic fever (see below). Diagnosis: The most widely used diagnostic test is the Jones’ Criteria, which states that a patient has at least the required criteria, two major criteria and no minor criteria or the required criteria, one major criteria and two minor criteria. Epidemiology: Conclusion: Due to an increase in immigration in recent years, cases of Rheumatic Heart Disease have seen a marked increase in the United Kingdom and the United States of America.
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