心臟病及保健 Heart Disease And Health http://心臟病.tw www.heartdisease.idv.tw
RHEUMATIC HEART DISEASE
Andrew Ying-Siu Lee, MD,PhD.
Group A B hemolytic streptococcus infection of the tonsilopharynx (known as rheumatic fever) will affect
the heart (rheumatic carditis), joints (arthritis), nervous system (Sydenham’s chorea), skin and subcutaneous
tissues (erythema marginatum, nodules). Rheumatic carditis may affect the endocardium, myocardium,
pericardium and lead to fibrosis of heart valves, known as rheumatic heart disease.
Rheumatic fever usually occurs in young people (5-15 years old). Majority have no symptom. However,
some patients may have carditis, heart failure, pericarditis and even sudden cardiac death.
Therapy include bed rest, analgesics, steroids, antibiotics, supportive treatment. Long-term antibiotic prophylaxis
is needed if there is carditis. About 15 to 20 years after infection of rheumatic fever, the heart valves may become
calcified, thickened, atrophied or adhered, causing valvular stenoses or regurgitation. In this case, symptoms,
therapy and prognosis thereafter become similar to that of valvular heart disease (See “valvular heart disease”).