Anatomy and Physiology

The

heart is the organ that helps supply blood and oxygen to all parts of the body.

 Atria -

heart.

upper two chambers of the lower two chambers of

Ventricles -

the heart.

 Epicardium- the

of the heart.

outer layer of the wall

Myocardium Endocardium

the muscular middle layer of the wall of the heart. heart. - the inner layer of the

The Cardiac Cycle is the sequence of events that occurs when the heart beats. Below are the two phases of the cardiac cycle:
Diastole Phase - the heart ventricles are relaxed and the heart fills with blood. Systole Phase - the ventricles contract and pump blood to the arteries.

Aortic Valve - prevents the back flow of blood as it is pumped from the left ventricle to the aorta.
Mitral Valve - prevents the back flow of blood as it is pumped from the left atrium to the left ventricle. Pulmonary Valve - prevents the back flow of blood as it is pumped from the right ventricle to the pulmonary artery. Tricuspid Valve - prevents the back flow of blood as it is pumped from the right atrium to the right ventricle.

 Rheumatic fever

is an autoimmune disease that occurs as a reaction to a

group A beta-hemolytic streptococcus.

Rheumatic

fever can cause permanent damage to the heart, including damaged heart valves and heart failure.

Sydenhams chorea jerky, uncontrollable body movements

erythema marginatum- flat or slightly raised, painless rash with a ragged edge Arthralgia - joint pain without swelling subcutaneous nodules - painless lumps on tendons sheaths

Cross-reactivity- the reaction between an antigen and antibody that was generated against a different but similar antigen.

Antigen- substance that when introduced into the body stimulates the production of an antibody.
Antibody- any of a large variety of proteins normally present in the body or produced in response to an antigen which it neutralizes, thus producing an immune response

untreated group A beta hemolytic streptococcus infection

Immune activation

Invading microorganism attach themselves to the epithelial cell Stimulate prostaglandin release

Formation of antistrep antibodies

Destruction and injury to the tissue occur

Cross-reactivity

Cross reacts with endogenous tissue antigen in heart, joints,skin,brain and other tissue
Increase WBC (leukocy tosis)

Inflammatory process fever

Affects the skin

Attacks the joints

Attacks the heart

Affects the brain Alters neuronal function of the brain

fatigue

headache

Body weakness

Erythema marginat um

arthral gia

carditis

Sydenh ams chorea

Leukocytes accumulate in the affected tissue

Subcutaneous nodule

endocarditis

myocarditis

Clumps of bacteria and cells that form on the heart valve

Permanent damage to heart valve

Damage the heart valve

Rheumatic Heart Disease

Weakens the contractile power of the heart

Disruptions of the electrical conduction pathway

Heart cannot work properly Heart failure Compromising blood flow to other organs

Prolongation of the P-R in interval on ECG

DEATH

 The

signs and symptoms of rheumatic fever are divided to major and minor symptoms according to Jones Criteria.

Carditis
Polyarthritis Sydenhams chorea

Erythema marginatum
Subcutaneous nodules

Fever Arthralgia Leukocytosis Elevated sedimentation rate; C reactive protein Prolonged P-R interval on ECG due to slow impulse conduction.

NOTE: The Jones criteria require the presence of 2 major or 1 major and 2 minor criteria for the diagnosis of rheumatic fever.

Blood tests. test for a strep infection or history of a past strep infection. Chest X-ray. to look for heart enlargement.

Echocardiogram. test shows any heart inflammation or heart valve damage.

Electrocardiogram (ECG).measure the electrical impulses given off by the patient's heart. Throat culture. to gather a sample of secretions to be tested for strep bacteria.

ANTIBIOTIC to treat streptococcal infection

o generally I.M. penicillin or erythromycin

ANTI INFLAMMATORY- help decrease heart inflammation and joint pain

o Aspirin

CORTICOSTEROID- to reduce severe heart inflammation

o ORAL IBUPROFEN -

to reduce inflammation and joint pain

o ANTIPYRETIC- for fever

o SEDATIVES- if chorea is o Phenobarbital, diazepam

present

Bed rest Monitor vital signs Maintain hydration Monitor the patients pulse frequently, especially after activity to determine degree of cardiac compensation.

Provide comfort measures Provide safe, supportive environment for the child with chorea Administer medications punctually and at regular intervals to achieve constant therapeutic blood levels.

heart valve repair or replacement (heart valve surgery).

Smelter, Suzzane C., Bare, Brenda G., Hinkle, Janice L., and Cheever, Kerry H. Textbook of Medical-Surgical Nursing. 11t h edition. Lippincott Williams and Wilkins, c2008
Pillitteri, Adele. Maternal and Child Health Nursing. Vol. 2. 6th edition. Lippincott Williams and Wilkins, c2010

http://en.wikipedia.org/wiki/Rheumatic_fever
http://www.medicinenet.com/rheumatic_fever