Rheumocarditis. Physiotherapy and folk remedies

The pathological process in the membranes of the heart muscle and valve, resulting from an acute form of rheumatic fever that develops on the basis of an infectious disease, is called rheumatic heart disease. Not all patients are fully aware of what rheumatic heart disease 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 a dangerous pathology of the heart, the most common cause of which is untreated tonsillitis, and the result can be disability.

Rheumatic heart disease, often referred to as cardiac rheumatism, refers to heart diseases associated with inflammation of the connective tissues of various parts of the body along with the valvular apparatus. The pathological process starts in the muscular layer of the heart (myocardium), then spreads along the inner shell (endocardium) with a transition to the thickness of the outer layer (pericardium).

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

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

The 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 of articular rheumatism against the background of an infectious disease with a high temperature, most often it is streptococcal tonsillitis. Joint involvement is not yet detectable, but electrocardiography (ECG) results show characteristic interval changes.

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

dry-type pericarditis or with effusion, but without characteristic heart pain;
myocarditis during a mild form of rheumatism or severe diffuse pathology with acute heart failure, myocardial edema;
endocarditis, accompanied by an organic lesion of the mitral valve, a combination of severe myocarditis with signs of endocarditis.

If the patient often carries the acute form of primary rheumatic heart disease on his feet, then the onset of recurrent heart attacks is characterized by organic lesions of a rheumatoid nature. Recurrent seizures signal a formed valvular defect, pericardial fusion, scarring of myocardial tissues.

The pathogenesis of the rheumatic process during 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 rheumatic sclerotic changes without articular manifestations, leading to myocardial dystrophy, death of adults from severe heart failure.

A disease with a chronic relapsing course is difficult to diagnose. If the pathology is accompanied by a high temperature and constant or intermittent fever against the background of an increased erythrocyte sedimentation reaction, this is a signal of joint damage. In adolescent children, 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 heart disease 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 malfunctions in the heart.

Classification of rheumatic heart disease

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

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

Stage designation	Characteristic manifestations
Light	This form of the disease is not accompanied by obvious clinical symptoms of impaired heart function. The size of the organ is within the normal range, the noise is only of the organic type, no congestion is observed.
Average	With severe symptoms of rheumatic heart disease, organic noises are 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 a diffuse lesion of several cardiac membranes with significantly expanded boundaries of the organ. The disease is accompanied by circulatory failure accompanied by pericardial effusion.

For a severe form of rheumatic carditis, two types of development of overt symptoms are characteristic:

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

Phase of the course of the disease	The pathogenesis of the development of the disease
lingering	The process of inflammation with poor 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 heart disease with a moderate picture of clinical manifestations and a mild therapeutic effect.
recurrent	A continuous process of undulating flow - after an acute period, carditis passes into a phase of incomplete remission with a rapid lesion of internal organs.
Latent	The latent phase is characterized by the progression of rheumatic heart disease without classic symptoms, the disease is diagnosed with the appearance of heart disease.

From the point of view of chronic cardiac pathologies, rheumatic carditis is manifested by several types of diseases:

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

Please note: The most typical manifestation of rheumatic heart disease is 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 illness is associated with rheumatism, infectious and viral diseases.

When the lesion covers all layers of the heart, we are talking about the disease pancarditis. This kind of rheumatic carditis used to be common in children. To date, the disease is considered quite rare due to timely diagnosis and advanced methods of active therapy, which avoids the severe development of the disease. But the success of medical technology also does not allow to successfully cope with heart defects.

What causes rheumatic heart disease

The main cause of the classical form of pathology is a past infection of the upper respiratory tract mucosa (chronic tonsillitis, acute angina) caused by group A streptococcus. .

Under the toxic effect of the virus, mass infection of the tissues of the heart bag 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.

An equally important cause of rheumatic heart disease is the recurrence of a streptococcal infection. Doctors attribute the fact of re-infection to the most common causes of 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 heart rheumatism.

Characteristic signs of pathology

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

The development of cardiac pathology in children under 15 years of age is more severe. The child complains of incessant heart pains of high intensity, shortness of breath appears not only during exertion, but also at rest. Describing their condition, patients note a strong heartbeat rhythm, constant heaviness in the left hypochondrium, swelling in the legs.

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

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

Acute rheumatic carditis, which sometimes lasts up to two months, signals most clearly. The disease can proceed dry without pronounced symptoms or with an effusion, which is a serous fluid. The serous type of pathology is accompanied by shortness of breath with impaired breathing, edema of the cervicofacial region, tachycardia against the background of low blood pressure. The defeat of cardiac structures in various types of rheumatic diseases signals certain clinical symptoms.

Rheumatic endocarditis

Inflammation affects the valvular apparatus, which is accompanied by scarring of the affected cellular structures. The 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 leaflets of the mitral valve suffer from the inflammatory process, provoking myocardial insufficiency, which is diagnosed by symptoms:

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

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

Heart disease is manifested by inflammation of the organ membrane, it can develop with effusion into the cavity of the heart bag and without it. Pericarditis with effusion signals the following signs:

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

While listening to the patient, the doctor detects a muffled tone and noise effect associated with friction of the pericardium. In the dry form of the disease, pain syndrome and other vivid 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 signals inflammation of the muscle structures - the myocardium. The disease can develop according to a mild type (focal form) or proceed according to a severe scenario (diffuse myocarditis). The severity of symptoms is determined by the type of myocarditis, the non-dangerous focal form of the disease is accompanied by symptoms:

cardiac discomfort at rest;
various types of arrhythmia;
sounds of systolic murmur during listening.

Symptoms of the diffuse form of myocarditis are more severe, more often fatal. The beginning of the attack is accompanied by changes in the appearance of the patient:

Among other signs of a deadly condition, one can name 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 the weakening of the muscular frame, which can lead to loss of consciousness. A distinctive feature of diffuse myocarditis is periodic hemoptysis with severe febrile syndrome. In the course of listening to the patient, the doctor detects tones of specific noises with 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 recurrent type. Inflammation of the heart muscles (myocarditis) with stable rheumatic sclerosis without exudate progresses slowly, but causes the development of heart failure, liver cirrhosis.

Features of diagnostic measures

Diagnosis of rheumatic heart disease is performed according to specially developed clinical and laboratory criteria after objective conclusions based on the results of a general examination of the 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:

Of particular difficulty in diagnosing rheumatic heart disease are hidden current forms of the disease. In order not to confuse the symptoms of rheumatic heart disease with manifestations of other diseases, it is necessary to conduct the following types of studies:

laboratory blood tests reveal the presence of markers of the inflammatory process (the fact of leukocytosis, increased erythrocyte sedimentation rate), determine the level of antibodies to streptococcus, as well as C-reactive protein;
during the auscultatory diagnostic method, listening to noises, determining the tone of the heartbeat at different periods of breathing, the presence of loud noises in children and adults is associated with a defect;
during instrumental diagnostics, a cardiogram is made to detect rhythm disturbances, echocardiography for accurate visualization of changes, as well as a chest x-ray, which allows obtaining information about the parameters of the organ, signs of venous congestion.

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

Taking into account the results of the examination, the doctor draws up an individual program for the treatment of cardiac pathology. In the case of acute rheumatic heart disease, hospitalization is required with the appointment of bed rest for a month. According to clinical guidelines, diet #10 is indicated, based on limited salt intake, an increase in protein foods, fiber, an increased dose of vitamin C and potassium.

The main methods of treatment of rheumatic heart disease

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 amount of damage to the membrane of the heart wall, and the level of cardiohemodynamic disorders. At the initial stage pathology should be treated in a hospital with a full course of rehabilitation in a cardiological sanatorium. The continuation of drug therapy, which includes a number of therapeutic measures of various directions, is carried out on an outpatient basis under the nursing care and supervision of a rheumatologist.

Fight against body infection

Getting rid of the causative agent of streptococcal infection is performed according to the classical scheme by prescribing antibiotics of the penicillin line ("Erythromycin", "Penicillin"). In case of an allergy in a patient to drugs of the penicillin group, it is recommended to prescribe macrolides ("Azithromycin"), cephalosporins ("Cefuroxime"), lincosamides ("Lincomycin").

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

Relief of the inflammatory process

Inflammation associated with rheumatic carditis is treated with non-steroidal anti-inflammatory drugs. Most often, the drug "Diclofenac" is used, but if symptoms worsen, more powerful anti-inflammatory drugs of the glucocorticosteroid line (Prednisolone) will be required. After the abolition of the hormonal agent, this effect is fixed by the appointment of an additional course of Diclofenac.

The use of symptomatic therapy

In case of protracted rheumatic heart disease of a sluggish form or with a recurrent type of the disease, the appointment of drugs of 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), which require medical supervision.

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

Please note: Methods of cardiac surgery are shown based on the results of the formation of severe heart defects, accompanied by gross hemodynamic disorders with resistance to prescribed drugs. The choice of the type of surgical treatment is based on the severity of the defect and damage to the valve, which allows you to give preference to vulvoplasty or valve replacement.

Using folk methods

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

How to protect health

The main method of preventing the development of carditis is the timely treatment of streptococcus infection, regular sanitation of foci of chronic infection. A potential problem for a patient with rheumatic heart disease is the threat of a return of signs of the disease. Therefore, to prevent danger, the following rules will be required:

An important step in protecting against the onset of cardiac rheumatism should be the right lifestyle, including the choice of feasible physical activity during sports, the implementation of hardening procedures, which are important to start from a very young age. Preventive measures include actions to strengthen immunity, enrich the diet with natural vitamins, and follow a cardiological 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 heart disease. Restrictions are imposed on flour products, sweets and muffins. The patient's menu should include a sufficient amount of protein food of animal and vegetable origin, while observing a fractional diet in small portions in order to avoid overeating.

Risk of complications

Manifestations of heart rheumatism are associated with inflammation of the connective heart tissues, and the systemic course of the development of the disease affects the state of the whole organism. Among carditis, endocarditis and myocarditis are considered the most dangerous complications. Of the consequences of heart rheumatism, heart defects pose a threat, the consequences of which are:

heart failure with high blood pressure;
enlarged cavities of the heart with the threat of blood clots;
likelihood of ischemic stroke.

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

Forecast

If a person has had rheumatic heart disease, the severity of the disease will affect life expectancy. In the case of a mild development of the disease, identified in the initial phase, it increases in the patient, in contrast to the severe degree of any type of carditis, accompanied by recurrent heart attacks. The secrecy of the course of recurrent rheumatic fever leads to damage to the heart valves, the development of severe arrhythmia, and progressive heart failure.

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

Rheumatic heart disease is positioned as a serious manifestation of rheumatic fever. The classic form of this disease is a complete defeat of the heart wall, which captures 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 and the further development of a negative process cannot be avoided.

Disease pathogenesis

Cardiac 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 proceeds quite quickly. Approximately seventy percent of the examined patients have an increased activity of streptococcal bacteria, which are the causative agents of rheumatic heart disease.

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

But with the recurrent form of rheumatic heart disease, the presence of streptococci is not always confirmed. In some cases, other, poorly understood viruses are also the cause of the return of the disease.

Hereditary predisposition in adults and children gives rise to prerequisites for the occurrence of dangerous rheumatic heart disease.

Doctors distinguish the following reasons for the manifestation and further development of the inflammatory process of the heart walls:

Pneumonia;
Angina;
Scarlet fever;
Other infectious phenomena.

Rheumocarditis in children and adolescents is recurrent. Often, primary childhood rheumatic heart disease 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 attacks on the heart in sick children and adult patients differs. Their duration is also not the same and depends on the individual physical data of each person.

Symptoms of pathology

It is often possible to diagnose a disease only during a routine examination at a diagnostic center. If a patient develops an endocardial lesion, for several months he may not feel any manifestation of the disease, including discomfort. Therefore, for diagnosis, a direct examination is required.

Systolic and diastolic murmurs can only be detected by a qualified specialist with vast experience in cardiology.

Symptoms of rheumatic heart disease with the active development of the inflammatory process are manifested by unpleasant pain in the region of the heart 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 the development of rheumatic heart disease include:

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

You should not start such dangerous appearances and bring the progressive disease to fever, seizures and severe asthma.

Consultation with an experienced and qualified cardiology specialist will help you find out what caused the disease and how best to treat it to achieve positive results.

How to get rid of severe pathology

Do not count on the rapid treatment of rheumatic heart disease in children and adults. It will take a long rehabilitation period, maintaining bed rest and a certain routine.

To begin with, a special therapy is prescribed that has an effect on the human nervous system.

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

Inpatient treatment is prescribed for patients who have been diagnosed with primary rheumatic heart disease.

After the observation of doctors, a rehabilitation period will be required in one of the sanatoriums. An important role in the repayment of the main signs of the disease is played by drug therapy.

The following drugs are usually prescribed by medical specialists:

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

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

If there are no positive dynamic changes for a long time in the treatment of rheumatic heart disease, 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 its long-term use is 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 acute heart disease against the background of advanced rheumatic heart disease, specialists prescribe surgery, since other ways are powerless.

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

It often happens that rheumatic heart disease passes into a chronic phase and is congestive. Then it is recommended to use diuretic-type pharmacological agents, for example, Lasix.

Without proper timely treatment of the disease, it will progress and can lead to acute heart failure.

Rheumatism is a systemic inflammatory disease that most often affects the heart and joints. And if arthritis goes away with severe symptoms, then myocardial damage is often not diagnosed in an acute form. In this case, inflammation makes itself felt and can lead to serious damage to the organ. MedAboutMe figured out when to pay attention to the state of the cardiovascular system and how to protect the heart from a dangerous disease.

Rheumatism is a disease that is provoked by several factors at once. It rarely develops on its own, as a rule, the inflammatory process is a complication of the underlying infection. A combination of two factors leads to damage to the heart, joints and other organs and tissues:

Development of streptococcal infection.

The main cause of the pathology is A, which initially provokes other diseases. So, among the potentially dangerous ones, angina and scarlet fever are the first to appear, but any form of this bacterial infection can lead to rheumatoid fever. The danger to the body is the toxins that the microorganism produces. In particular, these poisons can significantly damage the heart.

Autoimmune reaction.

Rheumocarditis and other forms of the disease do not develop in everyone who carries a streptococcal infection. The fact is that a necessary condition for the development of inflammation is an autoimmune reaction, in which the immune system begins to attack its own cells. In some patients, in the connective tissue of the heart and blood vessels, there are components similar to streptococcus. With the development of the disease, the immune system is activated and destroys not only the bacteria, but also the tissues of the body. This predisposition is hereditary, so often heart rheumatism manifests itself in members of the same family.

Hereditary predisposition is an important component in the diagnosis of rheumatic heart disease. Therefore, if relatives had such a disease, after suffering a sore throat or scarlet fever, it is advisable to undergo a cardiological examination.

Symptoms of heart rheumatism

Rheumatism of the heart proceeds differently in different groups of patients. First of all, the prevalence of the inflammatory process varies. In severe cases, all membranes are affected - pancarditis develops. Sometimes the disease only affects the heart muscle (rheumatic myocarditis) or the inner lining of the organ (rheumatic endocarditis).

Rheumatism can be acute or subacute, and then the symptoms will be pronounced. With a hidden process, the patient's well-being does not change, and before the onset of complications, he may not know that he has suffered such a serious illness. Late diagnosis is also characteristic of a protracted process, in which the disease lasts more than six months and is manifested by rare discomfort. A dangerous form of rheumatism is relapsing chronic inflammation, since periods of remission are often confused with complete recovery. The next exacerbation of a person can be interpreted as a common malaise and, as a result, not be treated in full.

Common symptoms of rheumatic heart disease are:

Pain in the chest of varying intensity and duration.
Arrhythmias, palpitations.
Fatigue, drowsiness.
Shortness of breath, aggravated by any physical activity.
Swelling (may appear in the legs or neck).

Primary rheumatic heart disease, which develops within 1-2 months after a streptococcal infection, will also be accompanied by fever. Moreover, the temperature can then rise to 39-40 ° C, then normalize. In an acute course, arthritis also develops - the patient has pain and aches in large joints (knee, elbow, and others), they can become deformed. A distinctive feature of rheumatoid arthritis is a symmetrical lesion of the joints.

In childhood and young age, the inflammatory process can cause a severe form of heart damage - diffuse myocarditis. In this case, the organ greatly increases, allergic inflammation is observed, which leads to an increase in heart failure. Signs of a serious condition will be:

Severely labored breathing.
Pale cyanosis.
Severe weakness, up to fainting.
Swelling of the neck veins.
Lowering blood pressure.

If, after suffering an infectious disease, a person notices at least minor symptoms of heart damage, it is necessary to contact a cardiologist. To diagnose the disease, two main examinations are prescribed - biochemical and electrocardiography. Additionally, the patient can be referred for an ultrasound of the heart, x-rays, and so on.

The basis for the treatment of rheumatism of the heart is the elimination of the pathogen (streptococcus). In severe cases, immunoregulation is also recommended to suppress the autoimmune process. For these purposes, drugs of two classes are prescribed:

Antibiotics (often vancomycin and doxycycline) that are active against bacterial infection.
Glucocorticoids (prednisolone, dexamethasone and others), which inhibit the cells of the immune system and at the same time relieve inflammation. With an unsevere course of rheumatic heart disease, such drugs are often abandoned and replaced with non-steroidal anti-inflammatory drugs (aspirin, ibuprofen).

Diuretics (to relieve edema), cardiac glycosides (improve heart function), vitamin complexes and other drugs are used as maintenance treatment. The patient is shown hospitalization and constant monitoring by a cardiologist.

Risk of rheumatic heart disease

Heart rheumatism is one of the main causes of acquired valvular defects. This complication develops already in 20% of patients who have had rheumatic fever once. If the inflammation is prolonged or recurrent, the likelihood of such consequences increases dramatically. Valve insufficiency may go unnoticed for a long time. But over time, such a pathology will still lead to heart failure, in addition, the defect increases the risk of developing other dangerous acute conditions - arterial thromboembolism, heart attack or stroke. With the development of valvular disease, the only effective treatment is surgery. Deciphering analyzes online

General analyzes
Biochemistry of blood
Hormones

One of the consequences of the occurrence of diseases of the joints is rheumatic heart disease, which in turn is the main clinical manifestation in rheumatism.

With this disease, localization of the pathological process, as a rule, in the heart is observed. It should be noted that rheumatic heart disease is mainly found in children whose age varies from 7 to 15 years.
no, 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 second in the human body that the development of autoimmune disorders begins.

Rheumocarditis is expressed by attacks that develop 1.5-2 weeks after an acute infection in the nasopharynx.

Streptococcal infections are characterized by increased massiveness. They are responsible for providing direct or indirect damaging effects on the tissues of the human body due to the large number of toxins and antigens.

The causes of rheumatic heart disease include a 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 remedies used during treatment may not be suitable.

Kinds

To date, there are several types of a disease such as rheumatic heart disease, which differ in their severity. Their list consists of three degrees:

Severe degree, in which there are pronounced symptoms, expansion of cardiac boundaries, as well as circulatory failure;
Moderate severity, which is characterized by a multifocal lesion. As for the manifestations, they are not bright, but they cause the patient some discomfort. The boundaries of the heart are also expanding, 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 which medicines the doctor prescribes to the patient. There is also acute rheumatic heart disease and chronic, which in turn can cause inflammation in the patient's body, including in the joints.

Symptoms

History of rheumatic heart disease is characterized by the degree of damage to the myocardium of the heart.

The symptoms of this disease include focal and diffuse myocarditis with a different etiology. As a rule, the list of typical signs of rheumatic heart disease consists of:

increased speed ROE;
prolonged subfebrile temperature;
pulse instability with an increased tendency to heart rhythm disturbances (tachycardia).

It is possible to facilitate the diagnosis of rheumatic heart disease in the case of a combination of the disease and rheumatic polyarthritis or polyserositis. In this case, the doctor prescribes certain drugs for this particular situation.

As for the most recent periods of the disease, here the diagnosis is facilitated when symptoms appear that indicate damage to the endocardium and do not occur during myocarditis with a different etiology.

Rheumatic heart disease is characterized by increased duration and cycle in the development of rheumatism.

Another distinguishing feature of the disease is a tendency to exacerbations, leading to subsequent changes in cardiac activity and aggravating the present valvular disease. In any case, the outcome of rheumatic heart disease ends with varying degrees of damage to the heart muscles and the subsequent development of valve defects (usually mitral).

In severe cases, there is a possible occurrence of effusion pericarditis, embolism (in the case of atrial thrombosis), as well as rheumatic lesions of the coronary vessels, when blood circulation is disturbed and nutrients are not supplied, including to the connective tissues of the joints.

Diagnostics

During the examination of patients with rheumatic heart disease, an expansion is detected.
heart borders with muffled tones.

Heart murmurs appear, blood and electrocardiogram changes. As a rule, the treatment of rheumatic heart disease is aimed precisely at reducing the phenomena of an inflammatory nature and the absolute elimination of insufficiency in the heart.

Treatment

Rheumatic heart disease 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, there is an accession and pericarditis, which indicates a severe course of the disease. In the absence of treatment, the disease proceeds for two months, after which a latent form appears.

The process of treating patients with rheumatic heart disease 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 heart disease, tonsils are removed.

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

With an increase in heart failure, the list of drugs is supplemented by cardiac glycosides and vasodilators. In some cases, you can not do without an anesthetic.

The next direction in the treatment of rheumatic heart disease is preventive action in case of 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 twofold (spring and autumn).

Alternative treatment

For the treatment of rheumatic heart disease, folk remedies are also used, namely tincture, which includes 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 infused for a day. The use of this tincture is recommended for 1 glass half an hour before meals.

There are several other folk remedies with which you can treat rheumatic heart disease.

The tincture consists of 50 grams of finely chopped Eleutherococcus rhizome and 500 ml of alcohol or vodka. This composition must be put in a cool dark place for half a month. The mixture is stored in a dark bottle. The infusion is taken 30-50 drops 40 minutes before meals for a month.
Dry hawthorn flowers (10 gr.), filled with 100 gr. alcohol. All this is infused for 20 days in a dark place. After that, you need to strain the infusion and use 30-35 drops 4 times a day.
The main ingredients of another decoction are Eleutherococcus leaves (6 gr.), Which should be crushed and poured with 1 glass of warm water. This decoction must be put in an enameled closed vessel for 15 minutes. Then cooling takes place for 40 minutes. After that, you should strain it and add boiled water to the broth to get the initial volume.

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

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

After 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, anorexia, and weight loss.

The severity (acuteness) of the initial stage of ARF depends on the age of the patients. AT in childhood, as well as in middle-aged schoolchildren, in more than half of cases ARF develops acutely, according to the type of "outbreak". H After 2-3 weeks after a sore throat, the temperature suddenly rises to febrile, symmetrical migrating pains appear in large joints (most often knees) and signs of carditis (pericardial pain, shortness of breath, palpitations, etc.). The rest of the children have a monosyndromic course with a predominance of signs of arthritis or carditis or, which is very rare, chorea.

For teens and young adults a gradual onset is characteristic: after the subsidence of the clinical manifestations of angina, subfebrile temperature, arthralgia in large joints, or moderate signs of carditis appear.

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

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

multiwave lasting for weeks and months.

continuous (persistent) when the temperature (subfebrile) is constantly elevated for several months, no longer combined with articular phenomena.

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

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

Temperature rises are accompanied by sweating. Sweats in a patient with rheumatism have some features, they are usually copious, acrid, sour smell, prevail at night and lead to exhaustion of the patient.

Pulse - more often tachycardia corresponding to temperature. Tachycardia is only partly due to fever, and excessive and persistent tachycardia may indicate carditis.

2. The period of extended clinical manifestations.

Then comes the period of clinically developed disease. There are five main clinical signs (the so-called "great criteria" of rheumatism) specific to rheumatic fever:

Rheumatic carditis

Rheumatic arthritis

Subcutaneous rheumatic nodules

erythema annulare

Small chorea.

The central place in the clinical picture of ARF is occupied by heart damage, which determines the course and outcome of the disease as a whole.

Rheumatic carditis

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

Due to the difficulties in distinguishing between lesions of individual membranes of the heart in clinical practice, the generalized term "rheumatic carditis" has become widespread - a generalization of the concept of heart damage in rheumatism.

Until now, information about the frequency of myocardial damage is very contradictory. The data of some foreign researchers indicate that in the acute phase rheumatic heart disease occurs in 3-38% of cases, according to other data - in 48-73%. Domestic rheumatologists find carditis in the acute phase of RL in 89-100% of cases.

Rheumocarditis can be:

primary(in primary rheumatic fever);

returnable(recurrent rheumatic fevers), with or without established valvular disease.

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

The symptomatology of rheumatic heart disease is largely determined by the predominant lesion of one or another shell of the heart - myocardium, endocardium and pericardium, as well as the severity of changes in the heart.