How to Differentiate and Diagnose Rheumatic Heart Disease?

Update Date: 2024-05-16 Source: Network

Rheumatic heart disease is a serious condition that differs significantly from infectious endocarditis. It is typically caused by factors such as hemolytic streptococcal infection, migratory arthritis, or mitral valve abnormalities. In patients with rheumatic heart disease, diagnosis is often based on auscultation of the heart. The presence of murmurs or a rapid heart rate during auscultation typically indicates rheumatic heart disease, necessitating prompt medical attention.

The differential diagnosis of rheumatic heart disease primarily involves distinguishing it from infectious endocarditis. Although both conditions share some similarities, such as cardiac involvement, tachycardia, and heart murmurs, they also have distinct differences.

1. Hemolytic Streptococcal Infection: Rheumatic heart disease is primarily an immune-mediated disease caused by hemolytic streptococcal infection. It is a non-suppurative inflammatory disease of the connective tissue that affects both the heart and joints.

2. Migratory Arthritis: This condition is typically characterized by persistent low-grade fever accompanied by mental fatigue and arthritic manifestations. Migratory arthritis, often involving large joints, may be present, along with subcutaneous nodules and erythema. Laboratory tests may reveal increased white blood cell count, accelerated erythrocyte sedimentation rate, elevated C-reactive protein levels, and evidence of streptococcal infection.

3. Infectious Endocarditis: Infectious endocarditis primarily manifests as cardiac symptoms and may be accompanied by systemic fever with irregular fever patterns. Acute cases are often associated with high fever, while subacute infectious endocarditis typically presents with low-grade or moderate fever. Although skin and mucosal membranes may also be affected, the primary manifestations are petechiae and ecchymoses, which may be visible on the oral mucosa, conjunctiva, and anterior chest.

4. Mitral Valve: Additionally, in terms of cardiac murmurs, rheumatic heart disease primarily involves the mitral valve. However, infectious endocarditis not only affects the mitral valve but also primarily involves the aortic valve.