What is the pathophysiology of rheumatic fever?

What is the pathophysiology of rheumatic fever?

Acute rheumatic fever is a multiorgan inflammatory disorder affecting the heart, joints, brain, and skin. The pathogenic mechanism of molecular mimicry involves autoantibodies and T cells directed against group A streptococcal cell wall components and heart or brain antigens that have been extensively investigated.

Why does rheumatic fever affect the mitral valve?

How does rheumatic fever damage the heart? This infection causes swelling and muscle damage to the heart. It can also damage the heart valves in a way that keeps the blood from moving through the heart normally. The infection can cause heart valve leaflets to stick together, which narrows the valve opening.

Which valve is most commonly affected by rheumatic heart disease?

Rheumatic heart disease most commonly affects the mitral valve (which has only two leaflets; Figure 2) or the aortic valve, but any valve can be affected, and more than one can be involved.

What is the difference between rheumatic fever and rheumatic heart disease?

Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. Rheumatic fever is an inflammatory disease that can affect many connective tissues, especially in the heart.

When does rheumatic fever occur?

The onset of rheumatic fever usually occurs about two to four weeks after a strep throat infection. Rheumatic fever signs and symptoms — which result from inflammation in the heart, joints, skin or central nervous system — can include: Fever.

How does rheumatic fever affect the valves?

Although rheumatic fever can affect any heart valve, it most commonly affects the mitral valve which lies between the two chambers of the left side of the heart. The damage can cause valve stenosis, valve regurgitation and/or damage to the heart muscle.

How does rheumatic fever cause aortic regurgitation?

Rheumatic fever is a complication of strep throat and was once a common childhood illness in the United States. It can cause the aortic valve to become stiff and narrow (stenosis), causing blood to leak.

How does rheumatic fever affect the aortic valve?

Rheumatic fever can lead to scarring of the tissue in the aortic valve, causing the valve to become constricted and narrowed. This scarring can also increase the likelihood of calcium deposits building up along the valve — a major risk factor for aortic valve stenosis in adulthood.

What murmur is associated with rheumatic fever?

The Carey Coombs Murmur occurs during acute rheumatic fever. Mitral valvulitis can occur causing thickening of the leaflets. A murmur is created by increased blood flow across the thickened mitral valve.

What is the most common complication of rheumatic fever?

Rheumatic fever can cause long-term complications in certain situations. One of the most prevalent complications is rheumatic heart disease. Other heart conditions include: Aortic valve stenosis.

What does rheumatic fever do?

Rheumatic fever can cause permanent damage to the heart, including damaged heart valves and heart failure. Treatments can reduce damage from inflammation, lessen pain and other symptoms, and prevent the recurrence of rheumatic fever.

Can rheumatic fever cause aortic stenosis?

Pathophysiology of Rheumatic Fever. the joints, central nervous system, endocardium, and skin. This inflammation leads to damage to the tissues allowing for an increased risk of recurrence and further complications with the heart valves. There is also a genetic component to rheumatic fever that includes the HLA-DR 1 antigen and HLA-DR 6 antigen.

What is rheumatic fever (RSF)?

Rheumatic fever only occurs as a result of an untreated group A beta-hemolytic streptococcus pharyngeal infection. Rheumatic fever can affect the heart, joints, central nervous system, and skin. Symptoms result from an abnormal immune response to the M proteins on the microorgamisms that cross-react with normal body tissues.

What is the link between strep throat and rheumatic fever?

Group A streptococcus infections of the throat cause strep throat or, less commonly, scarlet fever. Group A streptococcus infections of the skin or other parts of the body rarely trigger rheumatic fever. The link between strep infection and rheumatic fever isn’t clear, but it appears that the bacteria trick the immune system.

What are Aschoff bodies in rheumatic fever (Ra)?

In acute rheumatic fever, Aschoff bodies often develop in the myocardium and other parts of the heart. Fibrinous nonspecific pericarditis, sometimes with effusion, occurs only in patients with endocardial inflammation and usually subsides without permanent damage.