Rheumatic Heart Disease in Indian Paediatrics: A Review

Keerthana Chandrasekar,Narenthiran C K,Vahini B

doi:10.9734/jpri/2021/v33i34a31819

Keerthana Chandrasekar, Narenthiran C K + Show 1 more

Open Access

https://doi.org/10.9734/jpri/2021/v33i34a31819

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Abstract

Rheumatic heart disease (RHD) is a condition in which the valves of the heart are damaged, it is mainly caused by Group A Streptococcus, it mainly affects the paediatrics and young adults. Inflammation occurs in the joints, heart and blood vessels due to group A streptococcus. The exact pathogenesis of rheumatic heart disease is unknown. It is manifested as fatigue, chest pain and shortness of breath; pulmonary hypertension, heart failure are some of the complications of the disease. Endocarditis, viral myocarditis and prolapse of the mitral valve are the differential diagnosis of rheumatic heart disease. It is diagnosed by revised Jones and World Heart Federation criteria. Benzylpenicillin is the first-line drug for rheumatic heart disease, followed by oral Penicillin V, Erythromycin can be recommended. Paediatrics who are allergic to Penicillin Azithromycin, Erythromycin can be recommended based on Indian paediatrics and World Health Organization guidelines. It is prevented by reducing the exposure to infection in high-risk regions; treat with appropriate antibiotics; prevent recurrence of infections and complications. The aim of this review is to highlight rheumatic heart disease in paediatric population.

Highlights

Acute Rheumatic fever (ARF) is mainly developed by an autoimmune reaction which develops sequelae of pharyngitis mainly caused by Group A Streptococcus; the inflammation mainly occurs in the heart, joints and blood vessels due to rheumatic fever
Paediatrics who are allergic to Penicillin Azithromycin, Erythromycin can be recommended based on Indian paediatrics and World Health Organization guidelines
As per Indian Pediatric and WHO guidelines treatment of rheumatic fever and rheumatic heart disease Benzathine Penicillin G, Penicillin V, Azithromycin, Cephalexin and Erythromycin is recommended for primary prophylaxis

Summary

INTRODUCTION

Acute Rheumatic fever (ARF) is mainly developed by an autoimmune reaction which develops sequelae of pharyngitis mainly caused by Group A Streptococcus; the inflammation mainly occurs in the heart, joints and blood vessels due to rheumatic fever. Recurrence of infections with Streptococcus pyogenes leads to rheumatic heart disease (RHD) [1,2]. It is defined as a cardiac condition where the valves get damaged permanently in the heart by Streptococcus species. Paediatric’s and adults with < 25 years of age living in poor hygiene areas are highly infected with rheumatic heart disease [3]. Since rheumatic heart disease is common in paediatric’s, our review aim is to highlight the pathology and the management in paediatric’s

EPIDEMIOLOGY

PATHOPHYSIOLOGY

Laboratory Test

To treat Streptococcus pharyngitis and clinical manifestations of the disease

Findings

CONCLUSION