Rheumatic Heart Disease

and Infective Endocarditis

Ammar K. Daoud, MD, FAAAAI
 Acute Rheumatic Fever
• Multi-system Disorder of Children
• Jones Criteria (Major, Minor and
Supporting evidence of Streptoccoal
infection)
• Managemet (Acutely Antibiotics, bed
rest, Aspirin, Corticosteroids,
Secondary prvention)
• Chronic Rheumatic Heart Disease
 Endocarditis
• Fever and Changing murmurs
• Many Signs
• Blood Cultures
• Echocardiography
• Antibiotics
• Prevention
 Valvular Heart Diseases
• All valves can be either Stenosed or Regurgitate
• Murmurs systolic (AS, PS, MR, or TR)
• Diastolic (AR, PR, MS, TS)
• Can be congenital or Acquired due to Rheumatic HD or
IVDU
• Leads to Arrhythmias or Heart Failure or incidental finding
• Has to be observed by Echo and when indicated Valve
replacement (Metallic with anticoagulation or Biologic)
• There is tendency to develop infection on the Damaged
valves (Infective Endocarditis) so they need prophylaxis
before procedures (Dental or Surgical)
 Congenital Heart Diseases
• Can be Valvular or Septal defects
(ASD or VSD) or great vessels
problem or Combined
• Can be discovered early or very late
• Can be cyanotic or acyanotic
• Has to be assessed and if needed
operated
• Give IE prophylaxis
 Infective Endocarditis
• Microbial infection of the heart valve
(Native vs. Artificial), lining of chamber
or blood vessel or congenital anomaly
• Right vs. Left
• Native valves (Strept, Staph, G-ve,
Hemophilus, Anerobes, Richettsiae,
Fung)
• Acute, Subacute and post-operative
 Infective Endocarditis
• Can be Acute or Subacute, Bacterial
or other types on damaged H valves
• Fever, New murmur or heart findings,
Anemia and Splenomegally
• Blood cultures is a must with Echo
• IV Antibiotics for 6 weeks
• BE prophylaxis