Rheumatic heart disease

Rheumatic heart disease (not to be confused with rheumatoid heart disease) may refer to either the acute cardiac involvement or chronic cardiac sequelae following rheumatic fever. Carditis is a major Jones criterion of rheumatic fever.

An increased prevalence in females have been reported 4.

Initial inflammatory events are precipitated by a group A Streptococcus pyogenes infection that causes a type 2 hypersensitivity reaction 7. The presence of Aschoff cells are a histological diagnostic feature.

Myocardial involvement

The Initial acute phase may result in a myocarditis which may progress to a dilated cardiomyopathy as later sequelae.

Pericardial involvement

Initially results in a pericardial inflammation and an effusion. A fibrinous pericarditis can occur. Pericardial calcification may occur as a later sequelae.

Valvular involvement

Valvular involvement is related to an endocarditis and can result in either stenosis and/or insufficiency, which can manifest either acutely or several years to decades after the initial onset of rheumatic fever. Most commonly the mitral valve is affected, producing a stenosis in later disease 2,6. Aortic regurgitation can also occur. Pathologically commissural fusion of valve leaflets is a characteristic feature.

Plain radiograph
CT
  • valvular or pericardial calcification
  • dilated ventricles and atria
MRI
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Article information

rID: 7503
System: Cardiac
Section: Pathology
Synonyms or Alternate Spellings:
  • Rheumatic cardiac disease

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