The patients are usually hospitalized, they must rest under strict supervision and rigorous treatment. These patients will usually have to remain bed-ridden for longer than patients with rheumatic polyarthritis.
A light diet containing vitamins and minerals in the form of milk, yoghurt, meat etc. During the moments when the fever spikes, their diet needs to be enriched with fluids. Patients who are concurrently suffering from cardiac insufficiencies have restrictions on the amount of fluids that they can consume and they are forbidden from consuming salt.
Cortisol and NSAID drugs are used.
If the patient must have a tooth removed during this time, the dentist must do this only after the passage of the acute phase and using antibiotics preventatively. For this purpose, it is necessary to treat the patient with antibiotics from 3 to 5 days prior and from 5 to 15 days following the dental procedure.
This kind of treatment not only prevents the return of the acute phase, but also prevents the entry of microbes, especially Streptococcus from entering the bloodstream and settling on the damaged valves, thus transforming the diagnosis into bacterial endocarditis.
Prophylactic treatment is usually conducted via the use of antibiotics, just as in cases of acute rheumatic polyarthritis. Each time these patients suffer from bacterial infections they must be immediately medicated with antibiotics. This is very important since often the future of a patient will depend on the outlook of the physician and this point in time.
Prognosis varies. It is usually less favorable in younger ages, in recurring endocarditis cases as well as in cases when other layers of the heart have been affected. Prognosis is usually unfavorable in forms that involve complications such as cardiac insufficiency and bacterial infections. Patients which have not sustained damage to the valves are recommended to take 1 to 2 months of complete rest, and to not conduct work in cold, humid environments, or at night. In patients who suffer from heart defects, prognosis depends on the overall condition of the myocardium, the degree of cardiac insufficiency, their profession, etc.
Rheumatic endocarditis is an inflammation of the endocardium. The inflammatory process if mostly localized in the valve endocardium, the layerÃƒâ€šÃ‚Â whichÃƒâ€šÃ‚Â covers the tendons and papillary muscles, and rarely the parietal endocardium may be affected.
Clinical symptomsÃƒâ€šÃ‚Â appear 8 to 10 days after the rheumatic attack and they include: high fever (rises and falls periodically), extreme fatigue, rhythm disruptions, a feeling of heaviness and pain in the precordium, dyspnea (difficulties breathing).
The main cause for this disease is theÃƒâ€šÃ‚Â betahaemolyticÃƒâ€šÃ‚Â StreptococcusÃƒâ€šÃ‚Â of group A, which is found in common infectious sites such as the mouth; in dental granulomas, dental abscesses,Ãƒâ€šÃ‚Â paradontosis, and other infections such as chronic tonsillitis.Ãƒâ€šÃ‚Â Ãƒâ€šÃ‚Â
A definitive diagnosis can be made via an objectiveÃƒâ€šÃ‚Â examination whichÃƒâ€šÃ‚Â will involve investigating for auscultative symptoms, which are the only symptoms which can belie potentialÃƒâ€šÃ‚Â damage of the endocardium.
Rheumatic endocarditis patients may suffer from the following complications:Ãƒâ€šÃ‚Â rhythmÃƒâ€šÃ‚Â disruptions (like arrhythmias), cardiacÃƒâ€šÃ‚Â insufficienc (which often constitutes the most common cause of death of these patients), infarctions and embolisms, etc.
Prophylactic treatment is usually conducted via the use of antibiotics, just as in cases of acute rheumatic polyarthritis. Each time these patients suffer fromÃƒâ€šÃ‚Â bacterialÃƒâ€šÃ‚Â infectionsÃƒâ€šÃ‚Â they must be immediately medicated with antibiotics.