CHAPTER 1 Cardiovascular System^49
- Explain to the patient:
- Stop smoking.
- Avoid cold.
- Inspect skin regularly for cracks and treat immediately to prevent infections.
- Moisturizers.
Rheumatic Heart Disease
WHAT WENT WRONG?
Rheumatic fever usually results from a prior upper respiratory infection with
group A streptococcus. It may lead to permanent valve disease and cardiac dam-
age, with the mitral valve being more commonly affected.
PROGNOSIS
Prognosis of rheumatic heart disease (RHD) depends on the amount of damage
done to the valves. When progressive valve disease occurs in the mitral valve, it is
imperative to recognize the early onset of atrial fibrillation, to ensure early initia-
tion of anticoagulation to prevent emboli.
HALLMARK SIGNS AND SYMPTOMS
- A new murmur of insufficiency S3
- Joint pain because of the inflammation
- Increased temperature greater than 100.3°F because it may signify infection
- Carditis—chest pain, heart failure, friction rub
INTERPRETING TEST RESULTS
- Increase in cardiac enzymes to look for other causes of chest pain
- Positive C-reactive protein, ESR which are elevated in inflammation
- Increase in WBC because it may be of infectious origin
- Echocardiogram to assess for damage to valves
17