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rheumatic heart disease nursing

Rheumatic fever is the cause of heart valve diseases obtained, both in children and adults, especially in developing countries. In developed countries the incidence of rheumatic heart disease began to decline, because the level of the economy better and more perfect prevention.

Rheumatic fever is an acute inflammation, which often begins on farings inflammation. While rheumatic heart disease is a disease of recurrent /
chronic.

Germs that cause rheumatic fever is Hemolyticus Beta Streptococcus Group A. Predisposisinya factor is kerentangan body's resistance to these germs.

Generally someone who is suffering from acute rheumatic fever about two weeks earlier had been suffering from a sore throat.

These studies have shown that rheumatic fever is caused by immunological reaction of antigen - antibody from the body. Formed antibodies against Strepticoccus precisely who should be the antigen. Organs are often attacked as follows: The heart, joints and brain.

Age children who often experience fever, rheumatism and rheumatic heart disease are between 6 to 15 years (school age).

Pathology.

Rheumatic disorders of the heart can be divided into two phases: acute and healing phase.

Critical of acute rheumatic

Rheumatic fever may strike all layers of the heart. Usually affected Endokardium endokard layer of the valves and cause swelling of the leaves of the valve.

At the edge of the area leaves the meeting place of collecting valve sediment grains that consist of Platelet and fibrin (vegetation). Sometimes the vegetation occurred in the chordae also Tendenae. Valve is often the case is mitral valve vegetation. Valves are rarely affected vegatasi aortic valve, tricuspid and pulmonic ..

Specific disorders are caused by rheumatic karditis "Aschoff Body" which is composed of plasma cell lymphocytes and eosinophils. Fregmentasi interstitial collagen network found in areas surrounding necrotic tissue.

Networks that exist in the valve can cause the affected valve stenosis.

Diagnosis

To establish a diagnosis of acute rheumatic fever JONES CRITERIA used consisting of the criteria of major and minor criteria.

Major Criteria

    * Karditis: inflammation of the heart (myocarditis, endocarditis)
    * Poliartritis: patients complaining of pain in the joints that move, inflammation of large joints, knees, ankles, wrists, elbows (poliarthritis Migrans).
    * Khorea Syndenham: unintentional movement / motion abnormalities, as a manifestation of inflammation in the central nervous system.
    * Erythema marginatum: reddish marks on the torso and palms that do not itch.
    * Subcutaneous nodules: is located on the surface terutam extensor elbow joints, knuckles, knees, joints of the feet; no pain and may be freely moved.

Minor criteria.

    * Has a history of rheumatic fever or rheumatic heart disease.
    * Artralgia or joint pain without objective signs in the joints, patients are sometimes difficult to move the legs.
    * Fever is not more than 39 degrees Celsius.
    * Leukocytosis
    * Increased blood erythrocyte sedimentation rate (ESR)
    * C-Reactive Protein (CRP) positively
    * P - R interval lengthening.
    * Increased pulse / heart rate during sleep (sleeping pulse)
    * Increasing the Anti Streptolisin O (ASTO).

Diagnosis is established when:

   1. There are two major criteria and one minor criteria.
   2. There are two criteria for minor and one major criterion.

Medical treatment of the following aims:

    * Eradicate Streptococcus Infection
    * Prevent complications karditis
    * Reduces pain, fever.

Chronic rheumatic Karditis.

Rheumatic endocarditis caused by repeated it happens-tissue formation of connective tissue in the leaves of valves and chordae tendenae so that eventually became contractures. Komisura cause adhesions in the area so that the leaf valve chordae shortening and narrowing occurs valve stenosis, especially mitral valve. In addition to stenosis slide valve insufficiency also occur, where there are perkapuran on komisura, valve tissue contractures. nursing