Rheumatic heart disease

Rheumatic heart disease

Acute rheumatic fever

Acute rheumatic fever usually affects children (most commonly between 5 and 15 years) or young adults
it become very rare in Western Europe and North America.
However, it remains endemic in parts of Asia,Africa and South America,

The condition is triggered by an immune-mediated delayed response to infection with specific strains of group A streptococci, which have antigens that may cross-react with cardiac myosin and sarcolemmal membrane protein.

Antibodies produced against thestreptococcal antigens cause inflammation in the endocardium, myocardium and pericardium, as well as the joints and skin.
Histologically, fibrinoid degeneration is seen in the collagen of connective tissues.

Aschoff nodules are pathognomonic and occur only in the heart.
They are composed of multinucleated giant cells surrounded by macrophages and T lymphocytes, and are not seen until the subacute or chronic phases of rheumatic carditis.

Acute rheumatic fever is a multisystem disorder
usually presents with fever, anorexia, lethargy and joint pain, 2–3 weeks after an episode of streptococcal pharyngitis.
There may, however, be no history of sore throat.