Rheumatic Heart Disease RHEUMATIC HEART DISEASE Title

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					                                 RHEUMATIC HEART DISEASE

Title:

Rheumatic Heart Disease

Description:

Rheumatic heart disease was believed to be caused by direct infection of myocardial or valvular
structures. Contamination of the culture media and secondary postmortem localization of
organisms are the likely explanations for these positive results. Although Dundas did not
appreciate the significance and severity of valvular lesions in rheumatic heart disease and the
description of his autopsy findings lacks some degrees of precision, cardiac lesions in his
patients resulted rheumatic arthritis.

Brief Description:

In one case the affection of the heart appeared at the commencement of the rheumatic fever,
and its action was so rapid, that the pulse could not be counted for many days; much
difficulty of breathing and oppression attended with a sense of great debility took place,
and the inflammation, pain, and swelling of the extremities , after having shifted from one
joint to another for many weeks, subsided; but the affection of the heart continued,
generally attended with great pain, producing in the progress of the disease, and toward its
close, a considerable disposition to dropsy [congeative heart failure], under which the the
patient lingered for ten months.

Congestive heart failure with anasarca was the most common cause of death among these
patients. In that regard, Dundas noted: Towards the conclusion of the disease symptoms of
water in the chest take place, the legs become oedematous, and frequently considerable
collection of water is accumulated in the abdomen.

Dundas explained the relationship between rheumatic arthritis and cardiac manifestations as
follows:

The knowledge that this disease is always the consequence of, or is connected with, rheumatic
affection, points out the necessity of attending to the translation of rheumatism to the chest;
and shows the importance of employing very vigorous measures to remove it as soon as
possible, but whenever it has made any considerable progress, I fear it will battle every effort.

Although Dundas did not appreciate the significance and severity of valvular lesions in
rheumatic heart disease and the description of his autopsy findings lacks some degrees of
precision, he understood that cardiac lesions in his patients resulted from rheumatic arthritis.
Keywords:

Rheumatic heart disease, Rheumatic valve disease, Mitral disease, Heart Valve Surgery, Heart
Valve Repair, Heart Valve Replacement.

URL:

http://www.themitralvalve.org/mitralvalve/clinicalpresentationpathophysiology

				
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