A Case Report on Rheumatic Heart Disease
Akshatha
V Pharm D, TVM College of Pharmacy, Ballari, Karnataka, India.
Greeshma Raju
TVM College of Pharmacy, Ballari, Karnataka, India.
Vibitha Vinod
TVM College of Pharmacy, Ballari, Karnataka, India.
Sara Babu
TVM College of Pharmacy, Ballari, Karnataka, India.
Angel Sunny
TVM College of Pharmacy, Ballari, Karnataka, India.
Nagarjuna D *
Department of Pharmacy Practice, TVM College of Pharmacy, Ballari, Karnataka, 583104, India.
RS Meghasri
Department of Pharmacy Practice, Akshaya Institute of Pharmacy, Tumakur, Karnataka, 572106, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Rheumatic heart disease is caused secondary to rheumatic fever. Rheumatic fever, a systemic immune response to a beta-hemolytic streptococcal throat infection, remains a significant health issue in developing countries.
Clinical Findings: This is a case report of Rheumatic heart disease in which a 19-year-old female patient was admitted to the hospital with chief complaints of cough with expectoration for 3 months (sputum of minimal quantity, white to yellowish in colour), bilateral lower limb swelling and joint pains for 2 months insidious in onset gradually progressive in nature. She did not have any comorbidities. So, based on her signs and symptoms the physician has advised her for CBC, 2D Echo, ECG, C3 & C4 test, chest X-ray, urine routine & analysis, thyroid profile, anti-nuclear antibody test (ANA) and ASLO (antistreptolysin) test. In which her hemoglobin, RBC, WBC and platelets levels were abnormal. Chest X-ray shown presence of cardiomegaly, Urine routine & Analysis shown 4-5 pus cells and 1-2 epithelial cells are seen/hpf. 2D echo shown Dilated chamber, Global LV dysfunction EF- 40%, MVP severe MR: PML (posterior mitral leaflet) calcified, Moderate Aortic regurgitation (AR), Inferior vena cava dilated. ECG shown sinus rhythm, T wave inversion on V1-V3. ASLO test was 549.5 mg/dL which confirms recent streptococcal infection.
Management: The treatment was initiated with Antibiotics, Proton pump inhibitors, Antiemetics, Diuretics, Anti-hypertensive, Corticosteroids and NSAID’s etc.
Outcome: Therefore Rheumatic heart disease can be prevented by preventing streptococcal infections or treating them with Antibiotics when they occur.
Keywords: Rheumatic heart disease (RHD), rheumatic fever, beta-hemolytic streptococcal, cardiomegaly, LV dysfunction, aortic regurgitation, mitral regurgitation (MR), mitral valve prolapse (MVP)