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Rheumatic Heart Disease and Homoeopathy


Rheumatic (roo-MAT’ik) heart disease is a condition in which the heart valves are damaged (Psora- Syphilis) by rheumatic fever, an inflammatory condition (Psora- Sycosis) affecting several body tissues including the heart, brain and joints.

Prevalence

It can affect anyone of any age but is more commonly seen in children.

Pathophysiology

Rheumatic fever develops as a consequence of a strep throat infection (Psora), also called strep pharyngitis (caused by b Streptococcus haemolyticus Lancefield group- A, Gram positive bacterium) that has progressed and been left untreated. It is the most common bacterial infection of the throat.

 

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Modified Jones criteria for diagnosis were first published in 1944 by T. Duckett Jones, MD. They have been periodically revised by the American Heart Association in collaboration with other groups. According to revised Jones criteria, the diagnosis of rheumatic fever can be made when two of the major criteria, or one major criterion plus two minor criteria, are present along with evidence of streptococcal infection. Exceptions are chorea and indolent carditis, each of which by itself can indicate rheumatic fever.

Major criteria

Migratory polyarthritis: a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.

Carditis: inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.

Subcutaneous nodules: painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.

Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snake like ring while clearing in the middle. This rash never starts on the face and it is made worse with heat.

Sydenham's chorea (St. Vitus' dance): a characteristic series of rapid movements without purpose of the face and arms. This can occur very late in the disease.


Minor criterias:

Fever
Arthralgia: Joint pain without swelling
Raised erythrocyte sedimentation rate or C reactive protein
Leukocytosis
ECG showing features of heart block, such as a prolonged PR interval


Supporting evidence of streptococcal infection: elevated or rising antistreptolysin O titre or DNAase.
Previous episode of rheumatic fever or inactive heart disease


Other signs and symptoms
Abdominal pain
Nose bleeds
Thanks Nilanjana for additions.

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