Rheumatic Heart Disease And Infective Endocarditis

Rheumatic Heart Disease and Infective Endocarditis Ammar K. Daoud, MD, FAAAAI

Acute Rheumatic Fever • Multi-system Disorder of Children • Jones Criteria (Major, Minor and Supporting evidence of Streptoccoal infection) • Managemet (Acutely Antibiotics, bed rest, Aspirin, Corticosteroids, Secondary prvention) • Chronic Rheumatic Heart Disease

Endocarditis • • • • • •

Fever and Changing murmurs Many Signs Blood Cultures Echocardiography Antibiotics Prevention

Valvular Heart Diseases All valves can be either Stenosed or Regurgitate Murmurs systolic (AS, PS, MR, or TR) Diastolic (AR, PR, MS, TS) Can be congenital or Acquired due to Rheumatic HD or IVDU • Leads to Arrhythmias or Heart Failure or incidental finding • Has to be observed by Echo and when indicated Valve replacement (Metallic with anticoagulation or Biologic) • There is tendency to develop infection on the Damaged valves (Infective Endocarditis) so they need prophylaxis before procedures (Dental or Surgical) • • • •

Congenital Heart Diseases • Can be Valvular or Septal defects (ASD or VSD) or great vessels problem or Combined • Can be discovered early or very late • Can be cyanotic or acyanotic • Has to be assessed and if needed operated • Give IE prophylaxis

Infective Endocarditis • Microbial infection of the heart valve (Native vs. Artificial), lining of chamber or blood vessel or congenital anomaly • Right vs. Left • Native valves (Strept, Staph, G-ve, Hemophilus, Anerobes, Richettsiae, Fung) • Acute, Subacute and post-operative

Infective Endocarditis • Can be Acute or Subacute, Bacterial or other types on damaged H valves • Fever, New murmur or heart findings, Anemia and Splenomegally • Blood cultures is a must with Echo • IV Antibiotics for 6 weeks • BE prophylaxis