Rheumatic carditis. Physiotherapy and folk remedies

A pathological process in the membranes of the heart muscle and valve, resulting from an acute form of rheumatic fever developing due to infectious disease, called rheumatic carditis. Not all patients are fully aware of what rheumatic carditis is, the symptoms of which are often confused with signs of other diseases. Therefore, it is important to find out how to recognize and treat dangerous pathology heart disease, the most common cause of which is untreated sore throat, and the result can be disability.

Rheumatic carditis, often referred to as cardiac rheumatism, refers to heart diseases associated with inflammation of connective tissues various departments organ together with the valve apparatus. The pathological process starts in muscle layer heart (myocardium), then spreads along the inner membrane (endocardium) with a transition to the thickness of the outer layer (pericardium).

Symptoms rheumatic carditis may progress in different people age categories and gender, but in children under 16 years of age the pathology is much more severe than in adults. Although the disease is diagnosed very rarely in children under 5 years of age. The clinic of rheumatic carditis can develop without clear signs inflammation, but the acute form begins unexpectedly with manifestations of high intensity.

Important: During routine examinations, it is impossible to detect a hidden form of pathology. The only method to detect rheumatic heart disease is to diagnose heart disease, which is one of the complications cardiac rheumatism.

Main types of clinical manifestations

According to clinical signs, inflammation can be primary or recurrent. The clinic of the first heart attack is accompanied by primary manifestations articular rheumatism against the background of an infectious disease with high fever, most often streptococcal tonsillitis. Joint involvement has not yet been detected, but electrocardiography (ECG) results show characteristic interval changes.

The onset of rheumatic changes can occur both in acute form and on an outpatient basis, without seeking medical attention. The lesion equally affects all parts of the heart muscle, manifesting itself with rheumatic symptoms:

dry pericarditis or with effusion, but without characteristic heart pain;
myocarditis in easy time forms of rheumatism or severe diffuse pathology with acute heart failure, myocardial edema;
endocarditis, accompanied by organic damage to the mitral valve, a combination of severe myocarditis with signs of endocarditis.

If the acute form primary rheumatic carditis the patient often endures on his feet, then the arrival of recurrent cardiac attacks is characterized by organic lesions rheumatoid nature. Recurrent attacks signal the formation of a valve defect, fusion of the pericardium, and scarring of myocardial tissue.

The pathogenesis of the rheumatic process with repeated attacks can develop according to two scenarios:

continuously relapsing type with signs of synovitis, extensive exudative and granulomatous phenomena, and for young patients can be fatal;
a stable type of rheumosclerotic changes without articular manifestations, leading to myocardial dystrophy and death in adults from severe heart failure.

A disease with a chronic relapsing course is difficult to diagnose. If the pathology is accompanied by high temperature and constant or periodic fever against the background of an increased erythrocyte sedimentation reaction, this is a signal of joint damage. In children adolescence symptoms of an obvious joint attack may be absent or manifested by atypical joint pain, fatigue against the background of retarded development.

Please note: Recurrent rheumatic carditis in young and adult patients may begin with symptoms of exacerbation of tonsillitis, requiring urgent treatment. With the spread of infection, the development of cardio-tonsillar syndrome leads to serious disruptions in the functioning of the heart.

Classification of rheumatic carditis

According to the 10th revision International classification diseases, rheumatic carditis belongs to the section Chronic rheumatic heart diseases, included in the subsection with the symbol I05-I09 (ICD-10 code). The severity of rheumatic carditis is determined by the presence of organic noise when listening to the heart, by the presence of cardiomegaly (increased organ size), pronounced signs heart failure.

Taking into account the manifestations of cardiac pathology, the development of the disease goes through the following main stages:

Stage designation	Characteristic manifestations
Easy	This form of the disease is not accompanied by obvious clinical symptoms impaired heart function. The dimensions of the organ are within normal limits, noises are only of organic type, stagnation not visible.
Average	For severe symptoms of rheumatic carditis organic noise accompanied by slight cardiomegaly. In the presence of foci of inflammation, there are no signs of congestive circulation.
Heavy	The severe form is manifested by diffuse damage to several cardiac membranes with significantly expanded boundaries of the organ. The disease is accompanied by circulatory failure accompanied by pericardial effusion.

The severe form of rheumatic carditis is characterized by two types of development of obvious symptoms:

The classification of rheumatic carditis according to the degree of development of clinical manifestations is as follows:

Phase of the disease	Pathogenesis of the development of the disease
Protracted	The process of inflammation with scanty symptoms is diagnosed within six months from the beginning of its development.
Acute	The sudden onset of heart disease with a wide range of symptoms requiring immediate treatment.
Subacute	The phase of active rheumatic carditis with a moderate picture of clinical manifestations and a weak therapeutic effect.
Recurrent	Continuous process of wave-like flow - after acute period carditis enters a phase of incomplete remission with rapid damage to internal organs.
Latent	The latent phase is characterized by the progression of rheumatic carditis without classic symptoms, the disease is diagnosed with the appearance of a heart defect.

From the point of view of chronic cardiac pathologies, rheumatic carditis manifests itself in several types of diseases:

In rheumatic pericarditis, inflammation covers all the membranes of the heart sac, which threatens the accumulation of pericardial fluid. Due to worsened blood flow and frequency-rhythmic disturbances, the risk of cardiac arrest increases.
The myocardium suffers from the manifestations of rheumatic myocarditis. Inflammation of the tissues of the heart muscle leads to the development of arrhythmia and the appearance of heart failure due to deterioration of contractile function.
Rheumatic endocarditis is accompanied by inflammation of the inner lining of the heart chambers involving the heart valves (valvulitis). This increases the likelihood of developing a defect, fusion of thickened tissues (stenosis).

Please note: Most typical manifestation Rheumatic carditis is considered endomyocarditis, which is a combination of two foci of inflammation - the membranes of the valves and the tissues of the heart muscle. The cause of the acute or chronic type of the disease is associated with rheumatism, infectious and viral diseases.

When the lesion covers all layers of the heart, we're talking about about the disease pancarditis. This type of rheumatic carditis used to be common in children. Today, the disease is considered quite rare thanks to timely diagnosis and progressive methods of active therapy to avoid severe development diseases. But success medical technologies also does not allow you to successfully cope with heart defects.

What leads to the development of rheumatic carditis

The main cause of the classic form of pathology is a previous infection of the mucous membrane of the upper respiratory tract (chronic tonsillitis, an acute variant of tonsillitis) caused by group A streptococcus. The unique antigenic properties of the cells of these viral agents trigger autoimmune aggression in the human body against the connective structures of its own tissues, to which the membranes of the heart belong.

Under the toxic influence of the virus, massive infection of the tissues of the cardiac sac occurs, and exoenzymes secreted by streptococci lead to damage to the organ at the tissue level. In the blood of most rheumatic patients, traces of specific antigens are found, which play the role of markers of the genetic cause of rheumatic pathology.

No less important reason Rheumatic carditis is considered a recurrent streptococcal infection. Doctors attribute the fact re-infection to the most common reasons rheumatism in adults and adolescents. Only 3% of patients suffering from this disease develop symptoms of rheumatic fever, which is associated with a hereditary predisposition. Pathogens of other types are not capable of causing complications leading to the progression of rheumatism of the heart.

Characteristic signs of pathology

The intensity of the development of symptoms of rheumatic carditis is associated with the location of the inflammation, as well as the intensity of its spread. In adult patients, the disease is characterized by a mild course with slight pain discomfort in the heart area; the main symptom of rheumatic carditis is shortness of breath during exercise and rhythm disturbances.

The development of cardiac pathology in children under 15 years of age is characterized by a more severe course. The child complains of incessant high-intensity heart pain, shortness of breath appears not only during exercise, but also at rest. When describing their condition, patients note a strong heartbeat, constant heaviness in the left hypochondrium, swelling in the legs.

Each form of rheumatic carditis corresponds to certain symptoms, but the general signs of the disease in the body are as follows:

bright symptoms of the rapid onset of the acute form appear suddenly within a month after a person has suffered a nasopharyngeal infection;
pain syndrome from the side of the heart, it is accompanied by a temperature of up to 38 ° C (long-term or spasmodic), fever;
cardiac symptoms develop (shortness of breath, increased heart rate, interruptions in organ function), accompanied by swelling of the lower extremities;
a pathological process in the body is indicated by general signs manifested by weakness, increased fatigue, lack of appetite, weight loss.

The most pronounced sign is acute rheumatic carditis, which sometimes lasts up to two months. The disease can occur dryly without pronounced symptoms or with effusion, which is a serous fluid. The serous type of pathology is accompanied by shortness of breath with impaired breathing, swelling of the cervico-facial area, tachycardia against the background low blood pressure. Damage to cardiac structures different types rheumatic diseases signals certain clinical symptoms.

Rheumatic endocarditis

Inflammation affects the valve apparatus, which is accompanied by scarring of the affected cellular structures. Loss of mobility of the membranes leads to disruption of the functioning of the organ, which is manifested by the development of heart defects. The mitral valve leaflets suffer from the inflammatory process, causing myocardial failure, which is diagnosed by symptoms:

severe weakness and dizziness;
fainting;
frequent breathing with cough, shortness of breath;
manifestations of tachycardia, signs of ascites (fluid accumulation in the peritoneum).

Important: Endocarditis is characterized by rapid pulse with heart pain associated with angina pectoris. But a distinctive feature of a pain surge is long-term pain, regardless of physical activity. The disease is difficult to treat, and a poor prognosis is the most common outcome of this type of rheumatic carditis.

Heart disease is manifested by inflammation of the organ lining and can develop with or without effusion into the cavity of the heart sac. Pericarditis with effusion is signaled by the following signs:

swelling of the neck and face, nodular rashes on the scalp and hands;
irregular breathing rhythm, as well as shortness of breath during exertion;
frequent heartbeat with sharp drop blood pressure;
epigastric discomfort (heartburn, belching) due to stagnation of bile.

While listening to the patient, the physician detects a muffled tone and noise effect associated with pericardial friction. In the dry form of the disease, pain and other noticeable symptoms are usually absent; the appearance of pain is associated with a complication of the disease process.

Rheumatic myocarditis

The development of this type of cardiac pathology is signaled by inflammation of the muscle structures – the myocardium. The disease can develop according to light type(focal form) or proceed according to a severe scenario (diffuse myocarditis). The severity of symptoms is determined by the type of myocarditis, which is not dangerous. focal form The disease is accompanied by symptoms:

cardiac discomfort at rest;
different kinds arrhythmias;
sounds systolic murmur while listening.

Symptoms diffuse form myocarditis is more severe and more often leads to death. The onset of an attack is accompanied by changes in appearance patient:

Among other signs it is fatal dangerous condition can be called severe shortness of breath, it is accompanied by symptoms of tachycardia, pressing pain in the region of the heart. It is difficult for a person to move due to weakening of the muscular frame, which can lead to loss of consciousness. Distinctive feature diffuse myocarditis is periodic hemoptysis with severe febrile syndrome. While listening to the patient, the doctor detects specific murmurs during a galloping heart rhythm, which is manifested by complex signs of changes on the cardiogram.

Important: The most life-threatening form is considered to be recurrent myocarditis of a continuously relapsing type. Inflammation of the heart muscles (myocarditis) with stable rheumosclerosis without exudate progresses slowly, but causes the development of heart failure and liver cirrhosis.

Features of diagnostic measures

Diagnosis of rheumatic carditis is performed according to specially developed clinical and laboratory criteria after objective conclusions based on the results general examination patient. Due to the frequent absence of manifestations in the initial phase of the disease, the doctor should pay attention to the following important aspects:

It is especially difficult to diagnose rheumatic carditis due to hidden forms of the disease. In order not to confuse the symptoms of rheumatic carditis with manifestations of other diseases, it is necessary to carry out the following types research:

laboratory blood tests reveal the presence of markers of the inflammatory process (leukocytosis, increased erythrocyte sedimentation rate), determine the level of antibodies to streptococcus, as well as C-reactive protein;
During the auscultatory diagnostic method, murmurs are listened to, the tone of the heartbeat is determined different periods breathing, the presence of loud noises in children and adults are associated with the defect;
During instrumental diagnostics, a cardiogram is taken to identify rhythm disturbances, echocardiography to accurately visualize changes, and an x-ray chest, which allows you to obtain information about the parameters of the organ, signs of venous stagnation.

Please note: Auscultation with direct or indirect method listening is the simplest measure for identifying cardiac problems at the stage of their inception. Therefore, examination should be prescribed for elderly patients and children, as well as women during pregnancy.

Taking into account the results of the examination, the doctor draws up individual program treatment of cardiac pathology. In case of acute rheumatic carditis, hospitalization with prescription is required bed rest for a month. According to clinical guidelines, adherence to diet No. 10 is indicated, based on limited salt intake, an increase in protein foods, fiber, and an increased dose of vitamin C and potassium in the diet.

Basic methods of treating rheumatic carditis

When choosing tactics for monitoring a patient with rheumatic heart disease, as well as a drug therapy regimen, the doctor takes into account the activity of inflammation, the extent of damage to the lining of the heart wall, and the level of cardiohemodynamic disorders. On primary stage pathology should be treated in a hospital setting with full course rehabilitation in a cardiological sanatorium. Continuation of drug therapy, which includes a number of therapeutic measures of various directions, are performed on an outpatient basis under nursing care and supervision of a rheumatologist.

Fighting infection in the body

Getting rid of the pathogen streptococcal infection performed according to the classical scheme by prescribing antibiotics from the penicillin line (“Erythromycin”, “Penicillin”). If the patient is allergic to drugs penicillin group, it is recommended to prescribe macrolides (Azithromycin), cephalosporins (Cefuroxime), lincosamides (Lincomycin).

Primary rheumatic carditis in young children is usually treated acetylsalicylic acid (daily dose is 1.5 g) or Brufen, calculating the dose according to the principle of 20 mg active substance per kilogram of weight. After discharge from the hospital, patients are advised to continue taking Aspirin for 1-2 months.

Relief of the inflammatory process

Inflammation accompanying rheumatic carditis is treated with nonsteroidal anti-inflammatory drugs. The most commonly used drug is Diclofenac, but if symptoms worsen, more powerful anti-inflammatory drugs from the glucocorticosteroid line (Prednisolone) will be required. After cancellation hormonal agent this effect is secured by prescribing an additional course of Diclofenac.

Use of symptomatic therapy

For prolonged rheumatic heart disease sluggish form or in case of a recurrent type of disease, the prescription of drugs from the quinolone line (Delagil, Plaquenil) will be required. In the absence of the effect of antirheumatic therapy or the progression of rheumatism of the heart, they turn to the help of cytostatic immunosuppressants (Imuran, Chlorbutin), the use of which requires medical supervision.

Severe rheumatic carditis with signs of heart failure and heart disease is usually treated with cardiac glycosides (Strofanthin, Korglikon) with the addition of beta blockers, aldosterone antagonists, and ACE inhibitors. In the case of a congestive type of heart failure, a recurrent type of pathology, it is advisable to prescribe medications diuretic action(“Furosemide”, “Lasix”).

Please note: Cardiac surgery methods are indicated based on the results of the formation of severe heart defects, accompanied by severe hemodynamic disturbances with resistance to prescribed medications. Selecting a view surgical treatment based on the severity of the defect and damage to the valve, which makes it possible to give preference to vulvoplasty or valve replacement.

Using traditional methods

The symptoms of rheumatic carditis at the stage of exacerbation are not treated with folk remedies; physiotherapy methods are also strictly prohibited at this time. After the onset of a period of remission, it is allowed to take restorative tinctures with hawthorn fruits, decoctions of birch leaves, acacia inflorescences, willow bark and buckthorn. special healing power traditional healers attributed to vitamin mixture from dried apricots with raisins and honey.

How to protect your health

The main method of preventing the development of carditis is to carry out timely therapy infection with streptococcus, regular sanitation of lesions chronic infection. Potential problem a patient with rheumatic heart disease – there is a threat of a return of signs of the disease. Therefore, to prevent danger, the following rules will need to be followed:

An important step in protecting against the appearance of cardiac rheumatism should be correct image life, including the choice of feasible physical activity during sports, performing hardening procedures, which are important to start from a very young age. Preventive measures include actions to strengthen the immune system, enrich the diet natural vitamins, adherence to a cardiac diet.

Salt, various types of spices, as well as strong drinks (tea, coffee, alcohol) should be excluded from the diet of a person who has had rheumatic carditis. Restrictions apply to flour products, sweets and baked goods. The patient’s menu should include a sufficient amount of protein foods of animal and plant origin while observing a split diet in small portions to avoid overeating.

Danger of complications

Manifestations of rheumatism of the heart are associated with inflammation of the connective cardiac tissues, and the systemic progression of the disease affects the condition of the entire organism. Among carditis, the most dangerous complications are endocarditis and myocarditis. Of the consequences of rheumatism of the heart, heart defects pose a threat, resulting in:

heart failure with high blood pressure;
dilated heart cavities with the threat of blood clots;
the likelihood of ischemic strokes.

Please note: The development of myocardiosclerosis, associated with scarring of the tissue of the heart muscle, leads to disruption of the rhythm of heart contractions, which results in extinction contractility. These manifestations of heart disease require constant drug therapy and affect the patient’s life expectancy.

Forecast

If a person has had rheumatic heart disease, life expectancy will be affected by the severity past illness. When easy development of an illness identified in the initial phase, it increases in the patient, in contrast to the severe degree of any type of carditis, accompanied by recurrent cardiac attacks. The secrecy of the course of repeated rheumatic fever leads to damage to the heart valves, the development of severe arrhythmia, and progressive heart failure.

To achieve a positive prognosis after treatment of rheumatic carditis, increased vigilance is necessary, especially when hereditary predisposition to rheumatism. Compliance preventive measures at early diagnosis health problems will help protect all organs, including the heart, from life-threatening consequences of the inflammatory process.

Rheumatic carditis is positioned as a serious manifestation of rheumatic fever. Classic shape This disease is a complete lesion of the heart wall, which involves the endocardium and pericardium.

Removal of inflammatory processes is possible only with timely diagnosis and treatment. Otherwise, changes in the structure of the walls of blood vessels cannot be avoided and further development negative process.

Pathogenesis of the disease

Rheumatic heart disease often manifests itself due to streptococcal infection on the mucous membrane of the upper respiratory tract. The development of infection without proper treatment occurs quite quickly. Approximately seventy percent of examined patients are found to have increased activity streptococcal bacteria, which are the causative agents of rheumatic carditis.

The infection has a gradual toxic effect on the walls of the heart, which leads to an increased risk of mortality. The disease remains completely unexplored, but it is the development of inflammatory processes in the body, as many scientists believe, that serves as the impetus for its emergency development.

But when return form In rheumatic heart disease, the presence of streptococci is not always confirmed. In some cases, the return of the disease is caused by other, poorly studied viruses.

Hereditary predisposition in adults and children creates the preconditions for the occurrence of dangerous rheumatic carditis.

Doctors highlight following reasons manifestations and further development of the inflammatory process of the heart walls:

Pneumonia;
Angina;
Scarlet fever;
Other infectious phenomena.

Rheumatic carditis in children and adolescents is recurrent. Often, primary childhood rheumatic carditis is considered a natural consequence of rheumatism of the joints.

Also, the disease can be recurrent and lead to the development of severe and dangerous myocarditis. This disease usually leads to the most severe consequences.

The frequency of heart attacks varies between sick children and adult patients. Their duration also varies and depends on the individual physical characteristics of each person.

Symptoms of pathology

Often the disease can only be diagnosed during a routine examination. diagnostic center. If a patient develops endocardial damage, for several months he may not feel any manifestation of the disease, including discomfort. Therefore, direct examination is required for diagnosis.

Systolic and diastolic murmurs can only detect qualified specialist with extensive experience in cardiology.

Symptoms of rheumatic carditis with the active development of the inflammatory process are manifested by unpleasant pain in the heart area and disturbances in cardiac rhythms, which can be noticed by a medical specialist.

With endomyocarditis, a strong, often dry, mild cough occurs, which gradually intensifies.

Symptoms of the active stage of development of rheumatic carditis include:

Pulmonary edema;
Attacks of cardiac asthma, which are repeated more and more often;
Feverish phenomena;
Acute heart pain.

You shouldn't run something like this dangerous appearances and progress to fever, seizures, and severe asthma.

A consultation with an experienced and qualified cardiologist will help you find out what caused the disease and how best to treat to achieve positive results.

How to get rid of severe pathology

Don't count on fast treatment rheumatic carditis in children and adults. It will take a long time rehabilitation period, maintaining bed rest and a certain routine.

To begin with, it is assigned special therapy, which has an effect on nervous system person.

A special daily routine should be established for regularity, since being nervous during treatment is strictly prohibited. The slightest disruption can lead to a relapse.

Inpatient treatment is prescribed to patients who have been diagnosed with primary rheumatic carditis.

After observation by doctors, a rehabilitation period in one of the sanatoriums will be required. Drug therapy also plays an important role in extinguishing the main signs of the disease.

The following medications are usually prescribed by medical professionals:

Pyramidon and Aspirin;
Diphenhydramine;
Diclofenac;
Brufen;
Acetylsalicylic acid.

The daily dosage of medications can only be calculated by qualified medical specialist after a diagnostic examination.

If over a long period of treatment for rheumatic carditis there are no positive dynamic changes, doctors often prescribe the use of drugs from the group of glucocorticosteroids.

Prednisolone is the main remedy that belongs to this category. It can be prescribed to accelerate positive dynamics. But the drug has many side effects, so it long-term use not provided.

Hormonal pulse therapy- an alternative method of getting rid of the disease, which experts often insist on. But such therapy is not a classic treatment option and may not be used at all.

With the development of an acute heart defect against the background of advanced rheumatic carditis, specialists prescribe surgical intervention, since other ways are powerless.

Vulvoplasty will help relieve patients from the critical course of the disease and negative, life-threatening consequences.

It often happens that rheumatic carditis develops into chronic phase and is stagnant. Then it is recommended to use pharmacological agents diuretic type, for example, Lasix.

Without the right one timely treatment the disease will progress and can lead to acute heart failure.

One of the consequences of joint diseases is rheumatic carditis, which in turn is the main clinical manifestation for rheumatism.

With this disease, localization is observed pathological process usually in the heart. It should be noted that rheumatic carditis mainly occurs in children whose age ranges from 7 to 15 years
Yes, it is slightly less common in preschool children.

There is an inextricable link between the development of the disease and group A beta-hemolytic streptococcus. It is under the influence of the latter that the development of autoimmune disorders begins in the human body.

Rheumatic carditis is expressed by attacks that develop 1.5-2 weeks after past infection acute type in the nasopharynx.

Streptococcal infections are characterized by increased massiveness. They are responsible for causing direct or indirect damaging effects on tissue human body because of large number toxins and antigens.

The causes of rheumatic carditis include reduced level in the body's resistance to streptococcal infections. In this case, the doctor prescribes certain medicines to the patient.

There is also a family genetic predisposition to this disease. In this case, some of the medications used during treatment may not be suitable.

Kinds

Today, there are several types of diseases such as rheumatic carditis, which differ in their severity. Their list consists of three degrees:

Severe degree, in which there is a bright severe symptoms, expansion of cardiac boundaries, as well as insufficiency in blood circulation;
Moderate severity, which is characterized by multifocal lesions. As for the manifestations, they are not bright, but they cause the patient some discomfort. The boundaries of the heart also expand, however, there are no symptoms of insufficient blood circulation;
Mild degree with fewer lesions. At this stage there are no symptoms, cardiac boundaries are normal, and there is no circulatory failure.

It depends on the degree of the disease what medications the doctor prescribes to the patient. There is also acute and chronic rheumatic carditis, which in turn can cause inflammation in the patient’s body, including in the joints.

Symptoms

The history of rheumatic carditis is characterized in relation to the degree of damage to the myocardium of the heart.

Symptoms of this disease include focal and diffuse myocarditis with other etiologies. As a rule, the list of typical signs of rheumatic carditis consists of:

increased speed of ROE;
prolonged low-grade fever;
instability of the pulse with an increased tendency to heart rhythm disturbances (tachycardia).

It is possible to alleviate the diagnosis of rheumatic carditis in the case of a combination of the disease and rheumatic polyarthritis or polyserositis. In this case, the doctor prescribes certain medications specifically for this situation.

Most relevant later periods disease, then the diagnosis is facilitated by the appearance of symptoms indicating endocardial damage and not occurring during myocarditis with other etiologies.

Rheumatic carditis is characterized by an increased duration and cycle in the development of rheumatism.

One more distinctive feature The disease is a tendency to exacerbations, leading to subsequent changes in cardiac activity and aggravating the actual valve defect. In any case, the outcome is rheumatic carditis varying degrees damage to the heart muscles and the subsequent development of valve defects (usually mitral).

In severe cases there is possible appearance effusion pericarditis, embolism (in the case of atrial thrombosis), as well as rheumatic lesions coronary vessels when blood circulation is impaired and they do not receive nutrients, including to the connective tissues of the joints.

Diagnostics

During the examination of patients with rheumatic carditis, dilatation is detected
identification of cardiac boundaries with muted tones.

Heart murmurs appear, blood and electrocardiogram changes. As a rule, treatment of rheumatic carditis is aimed specifically at reducing the symptoms inflammatory in nature and absolute elimination of heart failure.

Treatment

Rheumatic carditis occurs in its mild form, characterized by damage to the myocardium of the heart without any other damage to the body. In this case, folk remedies can help.

Over time, pericarditis also develops, which indicates a severe course of the disease. If left untreated, the disease lasts for two months, after which a latent form appears.

The treatment of patients with rheumatic carditis must necessarily take place in a hospital. Anti-inflammatory drugs and antibiotic therapy are usually prescribed. If the patient has frequent tonsillitis, then in order to cure rheumatic carditis, the tonsils are removed.

If rheumatic carditis is severe, then the use of glucocorticosteroids (usually prednisolone) is necessary. During the treatment of the disease, a symptomatic treatment method is used. The doctor prescribes diuretics to the patient.

With increasing heart failure, the list of medications is supplemented with cardiac glycosides and vasodilators. In some cases, you cannot do without a pain reliever.

The next direction of treatment for rheumatic carditis is preventive actions during repeated attacks. It is necessary to carry out sanitation of foci of inflammation and hardening. During the first 3 years after the first attack, bicillin is prescribed, which the patient must take every month. Then the frequency of use is reduced to two times (spring and autumn).

Traditional treatment

Folk remedies are also used to treat rheumatic carditis, namely a tincture containing motherwort and hawthorn. To do this, you need to take 6 tablespoons of hawthorn and the same amount of motherwort. All this is poured with boiling water (1.5 liters) and left for a day. The use of this tincture is recommended 1 glass half an hour before meals.

There are several other folk remedies that can be used to treat rheumatic carditis.

The tincture consists of 50 grams of finely chopped Eleutherococcus rhizome and 500 ml of alcohol or vodka. This composition must be placed in a cool, dark place for half a month. The mixture is stored in a dark bottle. The infusion is consumed 30-50 drops 40 minutes before meals for a month.
Dried hawthorn flowers (10 g), filled with 100 g. alcohol All this is infused for 20 days in a dark place. After this, you need to strain the infusion and consume 30-35 drops 4 times a day.
The main ingredients of another decoction include eleutherococcus leaves (6 g), which should be crushed and poured into 1 glass warm water. This decoction must be placed in an enamel closed container for 15 minutes. Then cooling occurs for 40 minutes. After this, you should strain it and add boiled water to the broth to get the original volume.

The shelf life of the resulting infusion is no more than three days. The patient should take one tablespoon 4-5 times a day per half hour of meals for a month.

The period after streptococcal infection is latent and in most cases is asymptomatic or with signs of prolonged convalescence.

1.5 - 4 weeks after suffering a streptococcal nasopharyngeal infection, any of the characteristic manifestations occurs. Patients often present with complaints including fever, weakness, fatigue, sweating, lack of appetite and weight loss.

Expressiveness (sharpness) initial stage ARF depends on the age of the patients. IN In childhood, as well as in middle-aged schoolchildren, in more than half of the cases, ARF develops acutely, as an “outbreak”. H 2-3 weeks after a sore throat, the temperature suddenly rises to febrile, symmetrical migrating pain in large joints (most often the knee) and signs of carditis (pericardial pain, shortness of breath, palpitations, etc.) appear. The remaining children have a monosyndromic course with a predominance of signs of arthritis or carditis or, very rarely, chorea.

For teenagers and young adults characterized by a gradual onset: after the clinical manifestations of tonsillitis subside, low-grade fever and arthralgia appear in large joints or mild signs of carditis.

There is no typical temperature curve for rheumatism, but the following types of fever can be distinguished:

single-wave, expressed in one rapid rise temperature in 1-2 days to 38 - 39º with stabilization and subsequent lytic decrease, lasting 7-14 days.

multi-wave, lasting for weeks and months.

continuous (persistent) when the temperature (low-grade) is constantly elevated for several months, no longer combined with joint phenomena.

hyperpyretic, representing that type of fever, which reaches 41-42C, but is extremely rare.

Fever is usually associated with joint manifestations and is one of the most reliable symptoms.

Rise in temperature is accompanied by sweating. The sweats of a patient with rheumatism have some peculiarities; they are usually abundant, have a caustic, sour smell, predominate at night and lead to exhaustion of the patient.

The pulse is often tachycardic, corresponding to the temperature. Tachycardia is only partially explained by fever; excessive and persistent tachycardia may indicate carditis.

2. The period of full-blown clinical manifestations.

Then comes the period of clinically advanced disease. There are five main clinical signs(the so-called “major criteria” of rheumatism), specific for rheumatic fever:

Rheumatic carditis

Rheumatic arthritis

Subcutaneous rheumatic nodules

Ring-shaped erythema

Minor chorea.

Central place in clinical picture ARF is a lesion of the heart, which determines the course and outcome of the disease as a whole.

Rheumatic carditis

Features of rheumatic carditis include a tendency to sequential or simultaneous involvement of the membranes of the heart in the pathological process: myocardium, endocardium, pericardium.

Due to the difficulties of distinguishing damage to individual membranes of the heart in clinical practice, the generalized term “rheumatic carditis” has become widespread - generalizing the concept of heart damage in rheumatism.

To date, information about the incidence of myocardial damage is very contradictory. Data from some foreign researchers indicate that in acute phase rheumatic carditis occurs in 3-38% of cases, according to other data – in 48-73%. Domestic rheumatologists find carditis in the acute phase of LC in 89-100% of cases.

Rheumatic carditis can be:

primary(with primary rheumatic fever);

returnable(repeated rheumatic fevers), with or without established valve disease.

With primary rheumatic fever in children, carditis develops in 79-83% of cases, in adults - in 90-93% of cases. With repeated LC in adults, rheumatic carditis develops in 100% of cases.

The symptoms of rheumatic carditis are largely determined by the predominant damage to one or another lining of the heart - the myocardium, endocardium and pericardium, as well as the severity of changes in the heart.