Rheumatic Heart Disease Causes Heart Failure. How is It Treated?

Dian Rozani
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Abstract

Highlight: Rheumatic heart disease is among a leading cause of heart failure in school-age children. It discusses how to proper manage rheumatic heart damage Abstract: Rheumatic heart disease is the leading cause of heart failure in school-age children, affects 30 million people worldwide, and is still prevalent, especially in developing countries. Rheumatic heart disease was the result of untreated acute rheumatic fever. Knowledge of the proper management should be encouraged in those with rheumatic fever to halt the progression of cardiac damage that can lead to heart failure. This article discusses one such case. Case Summary. A 13-year-old girl complained of breathlessness during the activity, which improved with rest. She had a history of multiple joint pain and recurrent upper respiratory infection, which was not treated with antibiotics. On physical examination, the blood pressure was 90/60 mmHg, heart rate 128 bpm, facial and palpebral swelling, and the jugular vein pressure increased 5+3 cm H2O. The heart sound was S1>S2, regular with gallop and murmur in mitral, aortic, pulmonary, and tricuspid valves. Hepatomegaly and swelling of both lower extremities were discovered. Laboratories tests found ASTO 400 IU/ml. Chest X-Ray showed cardiomegaly. Echocardiography showed the regurgitation of mitral, aortic, tricuspid, and pulmonary valves. Discussion. The patient was diagnosed with heart failure fc. NYHA II ec rheumatic heart disease and treated with penicillin benzathine 1.2 units, furosemide injection 30 mg b.i.d, spironolactone 25 mg b.i.d, tenace 5 mg q.d, and prednisone 5-4-4 mg t.i.d. Adequate management of acute rheumatic fever can reduce the recurrence, prevent rheumatic heart disease and cardiac deterioration, and improve quality of life.
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风湿性心脏病导致心力衰竭。如何治疗?
重点:风湿性心脏病是学龄儿童心力衰竭的主要原因之一。摘要:风湿性心脏病是导致学龄儿童心力衰竭的主要原因,影响着全世界3000万人,并且仍然很普遍,特别是在发展中国家。风湿性心脏病是急性风湿热未经治疗的结果。应鼓励风湿热患者掌握适当的管理知识,以阻止可导致心力衰竭的心脏损害的进展。本文讨论了这样一个案例。案例总结。一名13岁的女孩抱怨在活动期间呼吸困难,休息后情况有所改善。患者有多发关节疼痛和反复上呼吸道感染病史,未使用抗生素治疗。查体时血压90/60 mmHg,心率128 bpm,面部、眼睑肿胀,颈静脉压升高5+3 cm H2O。心音S1>S2,规律,二尖瓣、主动脉瓣、肺动脉瓣、三尖瓣有跳动和杂音。肝肿大,双下肢肿胀。实验室检测发现ASTO为400 IU/ml。胸部x线显示心脏肿大。超声心动图显示二尖瓣、主动脉瓣、三尖瓣和肺动脉瓣反流。讨论。病人被诊断为心力衰竭。NYHA II型风湿性心脏病,给予苄星青霉素1.2单位、速尿注射液30 mg b.d、螺内酯25 mg b.d、坦尼松5 mg q.d、强的松5-4-4 mg t.i.d治疗。对急性风湿热进行适当的管理,可减少复发,预防风湿性心脏病和心脏恶化,提高生活质量。
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