What is the prognosis

What is the prognosis?
The first episode of rheumatic fever may last for weeks to months. Joint disorder is almost always over. Heart inflammation can cause permanent flap failure. The disease is associated with increased mortality both in the acute phase (myocarditis) and after (valve failure).

The immediate mortality rate is 1-2%. Patients who receive damages of palpitation has also increased the risk for serious complications from the heart later.

Treatment and diagnosis rheumatic fever

How is the diagnosis?
The diagnosis is based on the occurrence of several of the above symptoms or signs (Jones criteria), elevated blood sedimentation rate (ESR) and CRP , and laboratory detection of ongoing or recent infection with group A streptococci. ECG may show typical changes.

What is the treatment?
It is common to treat anyone with a penicillin cure for the eradication of streptococci from the throat.

The patient should keep quiet until the fever, and SR goes back and resting heart rate drops below 100.

There is no unanimous agreement among experts on the treatment beyond this. Anti-inflammatory medications are often used ( NSAIDs) , if necessary cortisone. However, this treatment is controversial, and there is no evidence that such treatment reduces the risk of heart disease.

If you have had rheumatic fever once, the risk is greatly increased for the new streptococcal infections can lead to a resurgence of rheumatic fever. With repeated episodes of rheumatic fever also increases the risk of serious heart disease. Therefore, it is common for children with rheumatic fever, and all who have had rheumatic fever with evidence of disease of the heart, recommended preventive treatment with penicillin for up to five years after initial rheumatic fever episode.

What causes Rheumatic Fever?

Rheumatic fever occurs after a preceding sore throat. Signs of rheumatic fever usually occur 2-3 weeks after strep throat infection, but symptoms can come as early as one week and as late as after five weeks. The prevailing hypothesis is that rheumatic fever caused by an autoimmune process triggered by a throat infection with group A streptococci.

Inflammation of the heart is the most serious effect of the disease. Mitral valve (the valve between the left atrium and ventricle) is attacked in 75-80% of cases, aortic valve in 30%.

Rheumatic fever signs and symptoms

Inflammation of the heart it is present in 80-90% it can appear as chest pain, heart rhythm disturbances and heart failure.

Joint Inflammation it appears on 2/3 of patients and is 2-4 weeks after streptococcal infection lasting 1-5 weeks and usually heal completely. Common inflammation often moving from joint to joint, sometimes lasts inflammation in some joints only a few days and then spread to the next paragraph.

Rash (erythema marginatum) itchy rash with sharp demarcation towards the periphery and more diffuse boundary to the center. The rash may come and go.

Nodule under the skin is a relatively uncommon consequence of rheumatic fever in adults, but is more common in children persists for days and weeks and can come back?

Sydenham's Korean (St. Veit Dance) can sometimes be the only manifestation of rheumatic fever this affects 10-40%. Sydenham's Koreans are more frequent in girls and are seen rarely in adults. There is abrupt, purposeless, and involuntary movements and muscle weakness. Often accompanied by emotional disturbances. The condition is alarming, but is almost always by themselves.