Slide 1

ACUTE RHEUMATIC FEVER

Acute rheumatic carditis

Pericarditis Chest pain Pericardial friction rub Myocarditis Tachycardia Heart failure Endocarditis MV is involves with/without involvement of AV/TVNew or changing murmur MV IS ALWAY AFFECTED

Valvular involvement in chronic rheumatic heart disease Mitral valve : 65-70%

Aortic valve : 25%

Tricuspid : 10%

Pulmonary : rarely involved

Clinical features Occur in 5-10% of caseInvoluntary semi purpose movements of body Involving limb/trunk/head/neck May affect speech Movements disappear during sleep Sydenham chorea

Other alternative drugs used Clarithromycin (in patient allergic to penicillin) 7.5mg/kg PO bid for 10 days Azithromycin (in patient allergic to penicillin) 12mg/kg (note to exceed 500mg) PO OD for 5days