Recurrent rheumatic heart disease

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The clinical picture of recurrent rheumatic heart disease as recurrent rheumatic fever in General, is significantly different from that of primary rheumatism. In the basis of these differences are primarily progressing as incurred repeated rheumatic attack represented at different levels of violation of regulatory processes. They are the direct result of deep changes in the state of inflammatory and immunological reactivity, tissues trophism, the evolution of the nature of the flow of rheumatic process with acute ischemia and significantly increased frequency of chronic variants of the disease. Carditis is essentially constant, and sometimes the only manifestation of rheumatism. In its clinical picture as incurred repeated rheumatic attack also occur characteristic changes: significantly grow symptoms of asthenia, vegetative disorders, thermoregulation. More pronounced become subjective manifestations of carditis with frequent complaints of shortness of breath, palpitations, interruptions, not associated with pericarditis painful feelings in the heart area.
In addition to the evolution of the characteristics of the course of carditis, changing its clinical picture appear in progressing as new recurrence of cardiac decompensation activities. In addition to diffuse and focal postmyocardial cardiosclerosis, the origin of the latter is important myocardiodystrophy, due dysmetabolic, autoimmune disorders, chronic overload attack. This progressive worsening cardiac pathology is associated with more profound and persistent violations conductivity at the level of the atrioventricular node, bundle, disorders of rhythm with the emergence of arrhythmia, paroxysmal tachycardia, atrial fibrillation, and other signs proof enough of diffuse and focal lesions of the myocardium. The growing insufficiency of blood circulation, combined with the increasing oppression of acute-phase reactions in protracted and latent period of rheumatic heart disease, becomes in the end, one of the leading manifestations of active rheumatic process in the heart.
Along with the trend towards disease to a chronic moneydrake forms, characterized by subtle manifestations of the General reactions, poorly expressed exudative component of allergic inflammation, a relatively small percentage of patients found the evolution of the opposite nature. It is observed the increase of readiness for common giperergicakie tissue reactions with the expressed prevalence of exudative component of inflammation, even more than in the acute form of the course, the tendency to multiple involvement in the process of organs and tissues. The result is the most unfavorable inherent predominantly return rheumatism continuous recurrent flow of rheumatic heart disease.
Dominant in the clinical picture of recurrent rheumatic carditis in acute and subacute during preserves typical of those options features. However, the severity of heart failure in connection with previous attacks, formation of the valve defect is usually more significant.