Flashcards in Acquired Heart Diseases - Unit 4 Deck (48)
Kawasaki disease - leading cause of heart disease in children. T/F?
Rheumatic fever - autoimmune response to group A beta-hemolytic streptococci (about _ to _ weeks after)
If there a difference between rheumatic fever and rheumatic heart disease?
YES - rheumatic heart disease occurs when rheumatic fever causes damage to the valves of the heart.
why is rheumatic fever an uncommon illness in developed countries today?
Antibiotic therapy! (thank god!)
where are the manifestations of rheumatic fever mainly seen?
Heart, joints, skin, CNS
what are aschoff bodies?
lesions that are found in all patients with rheumatic fever. Cause swelling and changes in connective tissue. Found in the heart, blood vessels, brain, joints, pleura, etc.
The mitral valve is the area of the heart that is affected most often in rheumatic fever, so a child with an ____ systolic murmur may have mitral regurgitation.
apical systolic murmur.
what are some manifestations of cardiac involvement?
tachycardia that is greater than the expected for a child with a fever, signs of heart failure, cardiomegaly, muffled heart sounds (due to pericarditis), chest pain
what are some other manifestations of cardiac involvement?
polyarthritis, erythema marginatum, subcutaneous nodules, chorea
what is polyarthritis?
swollen, hot, and red - usually affects knees, elbows, hips, shoulders, and wrists - aka the large joints! it works its way up.
what is erythema marginatum?
rash noted on trunk and proximal areas of extremities - reddened with a clear center and wavy border THAT DOES NOT ITCH!
what are subcutaneous nodules?
Rare, small, nontender nodules that may be found in clusters over bony prominences (knees, wrists, elbows)
What is chorea?
Sudden, aimless, irregular movements. can affect speech, extremity movements, can last months, etc.
What worsens chorea? what gender is it typically seen in?
Anxiety and deliberate attempts at fine motor activity. Chorea is seen mostly in female children.
what does an ASO titer indicate?
a recent streptococcal infection.
what is the jones criteria?
diagnosing rhemeuatic disease...MUST have 2 major or 1 major and 2 minor and evidence of a recent strep infection.
What are major things for the jones criteria?
Carditis, polyarthritis, erythema marginatum, subcutaneous nodules.
What are minor things for the jones criteria?
arthralgia, fever, increased ESR, increased CRP
how do we manage rheumatic disease?
Prevention (prevent strep infections!), prevention recoccurences, penicillin
once a child has had rheumatic fever, they are immune for life. T/F?
FALSE - they are actually more susceptible to recurrent rheumatic fever and they may need prophylactic antibiotics.
can we give aspirin to kids with rheumatic disease?
when can the child with rheumatic fever resume moderate activity?
when the fever subsides.
what rhythm might be seen in the child with rheumatic fever?
what is another name for infective endocarditis?
what is infective endocarditis?
infection of valves and inner lining of heart.
Who is at risk for infective endocarditis?
children with heart defects, children who have had heart surgery, children who have had rheumatic heart disease, and children with invasive devices.
Infective endocarditis has increased in pediatrics in recent years - T/F?
TRUE - it is thought to be due to the increased survival of children with heart defects.
how does infective endocarditis occur?
Microorganisms grow on a section of the endocardium that has experienced abnormal blood flow.
What are some signs/symptoms of infective endocarditis?
Unexplained low grade intermittent fever, malaise, headache, diaphoresis, weight loss, murmur changes, emboli formations