The information in the article is provided for informational purposes only and is not a guide to self-diagnosis and treatment. If symptoms of the disease appear, you should consult a doctor. 

Contents:

  1. Why does rheumatic carditis develop?

  2. Symptoms of rheumatic carditis

  3. What heart disorders does rheumatic carditis cause?

  4. Stages and forms of rheumatic carditis

  5. What is dangerous about rheumatic carditis?

  6. Diagnosis of rheumatic carditis

  7. Treatment of rheumatic carditis

  8. Prevention of rheumatic carditis

Rheumatoid arthritis – this is an inflammation of the heart. It is one of the manifestations of rheumatism – a systemic disease that affects all connective tissues of the body (joints, skin, lungs, heart).

Rheumatoid arthritis is most often diagnosed in children aged 6 to 16. In 20% of cases, the disease causes irreversible changes in heart tissue, the development of defects and heart failure. Complications can be avoided with early diagnosis and timely initiation of treatment.

Why does rheumatic carditis develop?

Rheumatic carditis develops as a complication of scarlet fever, angina, tonsillitis, or other diseases caused by group A beta-hemolytic streptococcus. In the human body, these microorganisms produce toxins that attack and destroy heart tissue. In addition, their chemical composition is close to the structure of connective tissue. As a result, when rheumatism develops, the immune system begins to attack not only foreign particles, but also the connective tissue cells that surround them. Thus, an infectious-inflammatory process develops in the heart and other affected organs. Most often, this occurs one and a half to two weeks after an acute illness.

The causes of rheumatic carditis are:

  • group A beta-hemolytic streptococci (scarlet fever, angina, chronic pharyngitis, etc.);

  • genetic predisposition.

Rheumatism and rheumatic carditis do not develop in everyone who has been infected with streptococcus. The disease is promoted by low immunity, hereditary predisposition, untimely start of treatment or incomplete recovery.

Symptoms of rheumatic carditis

Rheumatic carditis can manifest itself in different ways depending on the severity of the disease. In some patients, the disease is mild, accompanied only by minor chest pain and shortness of breath during heavy physical exertion. Others, on the contrary, suffer from severe pain in the heart, shortness of breath at rest, edema and other symptoms.

Rheumatoid arthritis can cause:

irregular heartbeat;

fever;

joint pain;

feeling of aches in the body;

  • pain in the heart area (aching or sharp, periodic or constant);

  • shortness of breath during physical exertion and at rest;

  • severe cough;

  • swelling of the legs;

  • pallor of the skin;

  • cyanosis of the fingers, lips and nose;

  • increased sweating;

  • weakness.

Often, the patient is more concerned about joint pain and swelling than about heart problems. Therefore, many do not consult a cardiologist in a timely manner and remain untreated for longer, which leads to an increase in pathology and increases the risk of complications.

What heart disorders does rheumatic carditis cause?

There are several types of rheumatic carditis, depending on which part of the heart is affected by the disease. Rheumatic carditis can cause:

  • endocarditis – inflammation of the inner lining of the heart, which can lead to valve dysfunction, the development of defects and heart failure;

  • myocarditis – inflammation of the muscle tissue of the heart, which can lead to arrhythmia and heart failure;

  • pericarditis – inflammation of the outer lining of the heart and the heart sac, which is accompanied by the accumulation of excess pericardial fluid;

  • pancarditis – inflammation of all heart tissues with impaired blood circulation and the threat of cardiac arrest.

Pericarditis and pancarditis – the rarest and most severe forms of rheumatic carditis. They are accompanied by severe symptoms, a significant deterioration in the patient's general well-being and can lead to serious complications.

Most often, rheumatic carditis manifests itself as inflammation of both the myocardium and the endocardium.

Stages and forms of rheumatic carditis

Rheumatic carditis is classified not only by the type of inflamed tissues, but also by the severity of symptoms and pathological processes.

There are 3 forms of rheumatic carditis:

  • mild - manifested by heart murmurs, other symptoms are mild;

  • moderate - the heart joins iomegaly, the size of the heart increases, the chambers expand and blood circulation is disturbed;

  • severe – circulatory failure develops and fluid accumulates in the pericardial sac.

According to the degree of damage to the heart tissues, 4 stages of rheumatic carditis are distinguished:

  • mucoid swelling – minor change in connective tissue;

  • fibrinoid swelling – deep and irreversible tissue change, accompanied by the breakdown of proteins, increased permeability of vascular walls, etc.;

  • granulomatosis – the appearance of rheumatic granulomas (nodules on the connective tissue);

  • sclerosis – scarring of the connective tissue.

This is a sequential process of destruction of heart tissue, which leads to the development of arrhythmia, heart defects, heart failure and other complications.

Also, depending on the duration of inflammation and the severity of symptoms, the following 5 forms of rheumatic carditis are distinguished:

  • acute – the disease develops rapidly, the patient's well-being worsens, he needs urgent treatment;

  • subacute – inflammation intensifies, but the symptoms of rheumatic carditis are less pronounced than in the acute stage;

  • recurrent – the degree of heart damage increases, but periods of exacerbation are replaced by improvement in the condition;

  • protracted – chronic inflammatory process, which proceeds for more than 6 months and is almost asymptomatic;

  • latent – hidden form of rheumatic carditis, which is diagnosed only after the development of complications.

What is dangerous about rheumatic carditis?

In the absence of timely treatment, rheumatic carditis causes irreversible changes in the heart. It can lead to necrosis and scarring of tissues, which is manifested by heart defects or impaired function. As a result, heart failure and cardiac arrest may develop. According to statistics, 60% of patients with stenosis (defect) of the mitral valve (located between the left ventricle and the atrium) previously had rheumatic carditis.

Complications of rheumatic carditis in adults and children can be:

  • arrhythmia – heart rhythm disturbances;

  • destruction of heart valves and impaired function;

  • myocardial sclerosis;

  • thromboembolism;

  • myocardial infarction;

  • cerebral stroke;

  • heart failure;

  • sudden cardiac arrest.

Diagnosis of rheumatic carditis

A cardiologist can diagnose rheumatic carditis. First, he examines the patient, checks for swelling, pallor, and cyanosis of the skin. After that, the doctor listens to the heart with a stethoscope, which allows you to detect noises. The specialist also asks the patient about the symptoms that bother him, previous infections, the presence of chronic diseases, etc.

To confirm the diagnosis, the following are performed:

The results of these examinations allow the doctor to make the correct diagnosis and, if rheumatic carditis is confirmed, determine the extent of heart damage.

The earlier the diagnosis is made and treatment is started, the higher the chance of a full recovery and the lower the risk of complications.

Treatment of rheumatic carditis

Rheumatic carditis is treated with medications. In mild forms of the disease, therapy is carried out on an outpatient basis, and in severe cases, hospitalization may be required.

The patient may be prescribed:

  • antibacterial drugs - to eliminate infection;

  • anti-inflammatory drugs - to relieve inflammation;

  • immunoregulators - drugs that block autoimmune processes (destruction of healthy cells by the immune system);

  • diuretics - to eliminate edema;

  • drugs to normalize heart rate, blood pressure and other means to eliminate the pathological process, symptoms of the disease and reduce the risk of complications.

The duration of treatment depends on the severity of the disease and its form.

In addition to drug therapy, the patient may be prescribed physiotherapy procedures, massage, therapeutic exercises and diet.

Prevention of rheumatic carditis

The main prevention of rheumatic carditis - is the timely treatment of all streptococcal infections. This is especially important for children, since rheumatic carditis is most often diagnosed between the ages of 6 and 16. Treatment of angina, erysipelas and other diseases is necessary