How to prevent rheumatic heart disease in children

The article was professionally consulted with Master, Doctor Do Nguyen Thuy Doan Trang - Cardiovascular Center - Vinmec Central Park International General Hospital.

Rheumatic heart disease is a dangerous disease and leaves many complications for organs in the body, especially if not treated promptly, the disease can lead to severe decompensated heart failure, even death. However, rheumatic heart disease in children can still be prevented if parents have ways to take care and protect children against the risk of disease.

Rheumatic fever (ARF), also known as rheumatic fever, or acute rheumatic fever is a condition of immune system mediated by infection with group A beta hemolytic streptococcus (Beta hemolytic Group A Streptococcus).
Rheumatic heart disease is considered the main cause of acquired heart disease in children aged 5-15 years. The disease causes damage to organs including: heart, joints, connective tissues under the skin and possibly the brain (rare).

Rheumatic heart disease in children causes lesions and causes symptoms in the heart, joints, skin, brain, and the whole body, specifically as follows:
Systemic signs: After being infected with streptococcus from 2 - 3 4 weeks, children may have a high fever from 38-40 degrees Celsius, nosebleeds, red throat, sweating, little urine, fatigue, poor appetite. These signs may only occur transiently in some children, after about 1 - 5 weeks, joint damage begins to appear. Signs in joints: Rheumatic heart disease causes typical lesions in many large joints (60-80%) such as pain in the knees, ankles, wrists, and elbows and is movable. When joints are painful, movement will be limited. Arthritis is often the earliest symptom of rheumatic fever, although asymptomatic myocarditis has preceded it. Rheumatoid arthritis usually leaves no sequelae. The disease is more common and more severe in adolescence than in young children. Cardiac signs: Damage to the heart usually occurs in the endocardium and myocardium, causing inflammation of the myocardium, endocardium, and pericardium. The disease causes endocarditis lesions such as aortic regurgitation, mitral regurgitation, and leads to symptoms such as chest pain, dyspnea, fatigue, palpitations, anxiety, restlessness, and arrhythmias. ,... Cardiac symptoms when a warning of rheumatic heart disease occurs at a dangerous level. These are common symptoms of the disease, if not detected and treated promptly can leave sequelae in the heart or even lead to death.

Signs in the brain: After many months of being infected with strep, the new disease causes damage to the brain - nervous system with symptoms such as involuntary movement and loss of sleep or inability to orientate, performing activities with a purpose, changing emotions, especially being emotional. Rheumatic heart disease in children affects the brain with specific symptoms such as irritability, abnormal limb movement, difficulty speaking, holding a pen, chopsticks, ... Skin signs: Lesions In the skin due to rheumatic heart disease are very rare, if present, are hard nodules that appear under the skin, mainly on the knees. The skin above this nodule is normally mobile and free of the above inflammatory manifestations. These particles do not stick to the skin, instead they stick to the bone and are painless when pressed. These particles last a few weeks but not more than 1 month. Occasionally, the lesions are circular, raised margins above the skin's surface, pink or pale yellow, usually on the trunk and extremities and never on the face. After a few days to a few weeks, these lesions may disappear. Rheumatic heart disease in children, if not recognized by the above-mentioned signs in time for treatment, can lead to dangerous complications and sequelae later.

Children who already have rheumatic heart disease need to be cared for, taken preventive and preventive measures to prevent the disease from progressing and causing sequelae. Specifically:
Antibiotic prophylaxis for children as prescribed by doctors, continuous treatment throughout adolescence. Echocardiography for children periodically. Children with valvular stenosis due to rheumatic heart disease must always pay attention to maintaining oral hygiene, brush teeth after meals to prevent tooth infection leading to bacteremia and endocarditis. . If there is a procedure or surgery or tooth extraction, it is necessary to inform the doctor about the child's rheumatic heart disease so that prophylactic antibiotics are prescribed first. Take your child for regular check-ups according to the doctor's instructions. Do not skip the follow-up appointment because it may not be timely to monitor the progress of the disease or the recurrence of the disease is dangerous. Risk factors for recurrence:
Non-compliance with relapse prevention History of multiple relapses Short distance from last low team) Young age History of rheumatic heart disease with heart inflammation and with/without sequelae of rheumatic heart valve disease Young children without rheumatic heart disease should be prevented as follows:
Regularly maintain a clean living environment Keep clean clean the body, ensure the hygiene of the nose and throat area is clean. If the child has a sore throat, tonsillitis or sinusitis, it is necessary to take the child to a medical facility with an ear, nose and throat specialist for thorough treatment. When children from 5 to 15 years old often have sinusitis, tonsillitis or pharyngitis, chest pain, joint swelling, hands dancing, involuntary activities, or abnormal psychomotor manifestations. .. Suspected of having rheumatic heart disease, children need to be examined immediately for timely detection and treatment and prevention of rheumatic heart disease. Keep neck, chest and throat warm in winter Improve resistance and immunity by eating adequate nutrients. Vaccinations for children are complete and on schedule.

Duration of prevention:
Rheumatic fever without valvular complications: at least 5 years after the last episode, until 18 years of age. Rheumatic fever with heart inflammation: 10 years after the last episode, up to age 21, continue for enough time despite surgery. Note: While receiving rheumatic fever vaccine level II, the injection should be changed to oral drug in the following cases:
Patient is suffering from severe heart failure Patient is suffering from another acute illness such as: Asthma, bronchitis , liver failure, kidney failure... Patients with indications: valve dilation, valve repair, valve replacement surgery... Diagnosis to promptly detect and treat streptococcal infections is a method of disease prevention. effective heart rate. In case of late detection and improper treatment, it can easily lead to severe heart failure, even death. Therefore, when there are warning symptoms of rheumatic heart disease, patients should go to medical facilities for examination, diagnosis and treatment as soon as possible.
At Vinmec International General Hospital, there is a team of Cardiologists who are experienced specialists, well-trained in diagnosis and specialized treatment of diseases related to the circulatory system. . In addition, Vinmec has a system of modern and advanced medical equipment, professional service quality, and the best support for diagnosis and treatment results.