Rheumatic heart disease

Arteriovenous Heart III

Rheumatic heart disease refers to the heart disease caused by rheumatic fever activity, involving the heart valve. According to the statistics of the World Health Organization, there are more than 15 million patients with rheumatic heart disease in the world, while 500,000 new people suffer from acute rheumatic fever every year, mainly due to group A hemolytic streptococcal infection, which is an autoimmune disease. More in the winter and spring season, cold, wet environment, the initial age is mostly young adults.

The incidence of rheumatic heart valvular disease involving different heart valves is different. According to the study results, the incidence of mitral valve disease is 100%, and the proportion of simple mitral valve disease is 46.7%, which is the highest, followed by mitral valve combined with aortic valve, simple aortic valve, tricuspid valve and pulmonary valve. The main lesions are edema and exudation at the edge and base of the valve, and gradually expand to the whole valve, even involving the chordae tendineus and papillary muscle, resulting in valve junction flap fusion, chordae tendineus fusion and shortening, and valve lobe fibrosis, stiffness, curling and calcification, resulting in valve opening stenosis or incomplete closure. Valve stenosis: valve junction adhesion, thickening, hardening, not fully open, small flap mouth, hinder the normal flow of blood. Valve insufficiency: tendon and papillary muscle hyperplasia, shortening, hardening, valve failure to close completely, blood regurgitation. The number of valve sites involved in rheumatic heart disease can be represented by one or more valve lesions in the mitral, tricuspid, or aortic valves. Combined heart valve disease is a disease involving two or more heart valves at the same time. Among them, the most common mitral valve combined with aortic valve double disease, accounting for about 48%-87% of combined valvular disease.

The initial stage of the disease often has no obvious symptoms, and the later stage is manifested as palpitation

Anxiety, fatigue, cough, limb edema, cough, hemoptysis, and even heart failure, causing life-threatening. Clinically, according to the progression of the disease, there are the following major changes:

(1) Palpitations, shortness of breath after activity, and even dyspnea, upright breathing, and inability to lie down at night;

(2) After slight activity or fatigue, cough, sputum with blood, it is easy to catch cold;

(3) Loss of appetite, that is to say, eating is not good for a period of time, gastrointestinal stasis may be poor digestion, stomach distention. Reduced urine volume, lower limb edema, abdominal distension, ascites, liver and spleen enlargement.

(4) Most patients appear two zygomatic and lip purple, that is, "mitral face".

(5) Palpitations are often caused by atrial fibrillation or arrhythmia, and rapid atrial fibrillation causes patients to feel uncomfortable, and even breathing difficulties or exacerbations, thus prompting patients to seek medical attention. Atrial fibrillation is also the main cause of atrial blood tie and even stroke in patients.

(6) Chest pain, chest pain caused by simple valvular disease is generally ineffective with nitroglycerin. Special complications: arrhythmia, thromboembolism, infective endocarditis, heart failure.