RHEUMATIC HEART

DISEASE
• a complication that sometimes follows a
streptococcal pharyngitis infection (strep
throat). Even one bout of rheumatic fever
may cause scarring of the heart valves,
resulting in stenosis (narrowing) of the
openings between the chambers of the
heart
• Mitral valve is the most common site of
stenosis.
• Mitral stenosis obstructs free flow of blood
pressure in the left atrium, the pulmonary
from theveins,
left atrium
and pulmonaryto the left ventricle.
capillaries is chronically elevated
The left atrium becomes dilated.
• pressure in the left atrium, the pulmonary
veins, and pulmonary capillaries is
chronically elevated
• pulmonary hypertension, pulmonary
edema, or congestive heart failure
 SIGNS OF HEART FAILURE
• persistent rales at the base of the lungs
• dyspnea on exertion,
• cough, and hemoptysis.
• Progressive edema
• tachycardia
 Classification of Heart Disease

• Class I: Uncompromised. No limitation of physical activity.

Asymptomatic with ordinary activity.
• Class II: Slightly compromised, requiring slight limitation of
physical activity. Comfortable at rest, but ordinary physical
activity causes fatigue, dyspnea, palpitations, or anginal
pain.
• Class III: Marked limitation of physical activity. Comfortable
at rest, but less than ordinary activity causes excessive
fatigue, palpitation, dyspnea, or anginal pain.
Markedly compromised.
• Class IV: Inability to perform any physical activity without
discomfort. Symptoms of cardiac insufficiency even at rest.
In general, maternal and fetal risks with classes I and II
disease are small but are greatly increased with classes III
and IV.
 MANAGEMENT
• Anticoagulants
• Antiinfectives
 GERMAN MEASLES
• a disease caused by the rubella virus.
•
 FETAL-NEONATAL RISKS
– Growth retardation
– Mental retardation
– Congenital glaucoma
– Cataracts
– Bony lesions
– Pneumonia
– Hepatitis
– Cardiac anomalies
– Deafness (80%)
 NURSING DIAGNOSIS
• Ineffective Family Coping
• Risk for ineffective health maintenance