PATHOPHYSIOLOGY OF RHEUMATIC HEART DISEASE
PREDISPOSING FACTORS
MODIFIABLE
1. Poor environmental sanitation
2. Malnutrition: BMI 17.3605
3. Uncompliance to treatment regimen
PRECIPITATING FACTORS
NON- MODIFIABLE 1. Recurrent Pneumonia
1. Age: 20 2. Exposure to dust, smoke, etc.
2.Gender: Male
3. Low Birth Weight
4. Untreated sore throat
Invasion of Hemolytic
streptococcal infection to normal
flora
Increase production of antigen
that circulates the system
Macrophages presents bacterial
antigen to lymphocytes
Activation of B-cells
 A
A
Autoimmune response

Cross reaction with cardiac

myofiber, myosin, and smooth
muscle of arteries

Cytokines\ release

Inflammatory process in the layers

Narrowing of valves
of the heart

Valve leaflet harden and shorten

Increased
blood
Valvular dysfunction
pressure:
140\100
Poor cardiac function

Difficulty of the heart to pump

Carvedilol

Increase cardiac workload

A
 A

Scarring of the heart valves that

damages the mitral valve

RHEUMATIC HEART DISEASE