'Acute Rheumatic Fever' hits the heart most
Acute Rheumatic Fever, targeting children aged 5-15 years, causes a series of complaints in the body, from joints to heart. While the disease leaves no permanent damage to the joints, it can impair heart function. For this reason, in medicine, acute rheumatic fever is called 'licking joints but the heart bites'.
Child Heart Diseases Specialist Şebnem Paytoncu points out that Acute Rheumatic Fever, which occurs after an untreated throat infection, can cause serious heart problems in children aged 5-15 years. Private Aegean Health Hospital physician Dr. Şebnem Paytoncu, "Sore throat pain in children, especially if seen with fever must be considered. The disease should be treated with appropriate doses, appropriate time. Pain, swelling, redness in joints after the throat infections seen, must be consulted before the pediatric heart diseases specialist. After a while, the heart begins to damage, "he says.
What is Acute Rheumatic Fever?
Acute Rheumatic Fever; "Group A Beta hemolytic Streptococcus" is a systemic disease that is initiated by the microorganism, known as "Beta" among people, after it enters the body.
'Systematic' because; it affects not only the joint, only the throat or the heart, but the whole system.
The microorganism enters the body through the upper respiratory tract, starts to produce some enzymes in the throat and destroys the tissues in this region. Throat infection develops within 3-5 days and
* Throat ache
* Weakness
* Fire
symptoms occur.
If the person is sensitive, if not treated appropriately, symptoms of 'acute rheumatic fever' occur on average 1-5 weeks after having a throat infection, often 3 weeks later.
-In what age range is the disease common?
School age and adolescence are the most frequent ages. There are rarely reported cases under the age of 3 and over the age of 20, but mainly the 5-15 age group is at risk.
- Acute Rheumatic Fever, which symptoms manifest itself?
Joint involvement:
* Joint pain, swelling, redness and fever. (Joint swelling and fever can be overlooked, so pain alone should also be considered.)
* Complaints can last from a few hours to a few days in the same joint.
* Joint involvement has a mobile feature. For example, one day when the child's left knee aches, the next day pain, right ankle passes. Five hours later, he disappears into the wrist.
* Unlike other diseases, it is remarkable that there is no symmetrical involvement in the joints. Complaints do not occur at the same time, in both knee joints or in both wrists.
Hasta My left knee had ached first and my right ankle had pain the next day tür.
* The disease always involves large joints: knees, ankles, hip joints, wrists, elbows ...
Heart involvement:
* The disease can hold all layers of the heart. Heart involvement can range from a simple valve failure to heart failure.
* If the valve develops inadequate chest pain, palpitations, weakness, panting, sweating, loss of appetite, cough is seen. These symptoms do not occur after the child plays games, but at rest, with no reason.
* If the heart muscle is involved, findings similar to heart failure occur. Swelling in the body, weakness, need to rest while walking the road is seen.
* If the membranes surrounding the heart are kept, chest pain and deterioration of heart function, that is again developing heart failure.
Skin and central nervous system involvement:
* If skin involvement occurs, skin rashes may occur.
* If the central nervous system involvement occurs, the child's school performance decreases. His writing and speech may be disturbed. Tics may develop. He cannot wear his own clothes, for example, he cannot button his buttons. With these symptoms, psychiatric disorders may also occur. Therefore, parents need to watch the child very carefully.
- Joints, heart, nervous system, skin ... The disease creates many different effects on the body. In which case should parents seek medical advice from a specialist for correct diagnosis?
In all diseases related to children, you should go to the pediatrician first. Because the pediatrician will perform a general systemic examination. So when the child has a sore throat, the first option should be the pediatrician and, if necessary, refer to another specialist.
-What is done for the diagnosis of the disease in patients presenting with these complaints?
On examination, a cardiac murmur or an increase in the severity of a murmur is not suspicious. ECHO should be performed to detect valve failure and the results should be repeated after 10-20 days even if the results are completely normal. ECO is useful in the evaluation of all functions of the heart, called 'silent carditis', which allows recognition of non-murmur heart inflammation. The presence of some supportive findings is questioned by ECG, and rhythm problems, if any, are revealed. In addition, throat culture is performed and the level of antibodies against the beta-germ causing disease is examined.
- How to treat?
First of all, the beta-germ causing the disease must be removed from the tissues with penicillin treatment. Therefore, penicillin is administered to the patient at the appropriate dose for 10 days.
If the patient is allergic to penicillin, alternative medications are used for this treatment. Then, in order to prevent recurrent attacks of the disease, these people continue their penicillin treatment for three days and three days for a long time.
Long-term penicillin treatment
- How long are penicillin treatments?
* No heart involvement, at least 5 years or 20 years old if there is inflammation of the joints,
* If there is heart involvement but rheumatic heart disease has not developed, say AT LEAST 10 YEARS OR 30 YEARS,
* If there is heart involvement and rheumatic heart disease has developed, life-long penicillin treatment should be continued.
- If acute rheumatic fever has only affected the joints, if there is no problem in the heart, how is it treated?
After making sure that there is no heart involvement, 2 weeks of definite bed rest (only for toilet needs), 2 weeks of home rest is recommended. In addition, acetylsalicylic acid (aspirin) is given to the patient at the appropriate dose for 2-4 weeks during this period and the treatment is ended by reducing the dose over time.
- What is the treatment of heart involvement?
Bed rest for 6-12 weeks, cortisone is applied in addition to acetyl salicylic acid treatment. Cortisone is used only in moderate to severe heart involvement. Heart failure treatment is given.
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