By ULY CLINIC staff
Rheumatic heart disease (RHD) in Children
Rheumatic Heart Disease
It is a complication of ARF which causes permanent damage to the heart valves.
Diagnostic Criteria
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Dyspnoea on exertion, cough, wheezing
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Orthopnoea
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Paroxysmal nocturnal dyspnoea
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Haemoptysis
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Exercise intolerance
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Bounding pulses, increased pre-cordial activity and impulse, displaced apical impulse, increased S2 if there is pulmonary hypertension.
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With evidence of valvular lesion on Echocardiogram.
Investigations
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ECG
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Chest-X ray
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Echocardiogram
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Cardiac catheterization
Treatment
Non pharmacological treatment
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Provide primary prophylaxis for infective endocarditis and secondary prophylaxis for acute rheumatic fever.
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Treat heart failure if present (refer to heart failure)
Note:
Patients with valvular damage should be referred to the next level facility with adequate expertise and facilities.
Last updated on 16.09.2020
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References
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Tanzanian Standard treatment guideline for children 2017 edition page 103