RHEUMATIC HEART DISEASE

RHD is the most readily preventable chronic disease.It results in continuing damage to heart, increasing disabilities and repeated hospitalization.It is consequence of RHEUMATIC FEVER.
RF is not a communicable disease but it results from a communicable disease which is sore throat caused by GROUP A BETA HAEMOLYTIC STREPTOCOCCI. 

RHD is a major cause of morbidity and mitral insufficiency.It must be prevented.

PRIMARY PREVENTION

-Practically it is not possible to avoid first attack of Rheumatic fever.

-In case of sore throat,it should be swabbed and cultured.If streptococci present then start PENICILLIN.

-If swab culture is not possible then it is justified to give

   a.-single IM 1.2 million U of Benzathine benzyl penicillin in adults

   b.-600000 uU in children

   c.-Oral penicillin for 10 days.

   d.- ERYTHROMYCIN is given in case of allergy to PENICILLIN.

SECONDARY PREVENTION

-It is more practical approach.

-It consists in identifying those who had taken penicillin at interval of 3 weeks.

-This must be continued for at least 5 years or until the child reaches 18.

-with carditis treatment should continue for 10 years after the last attack or up to 25 whichever is longer.

-more severe valvular disease or post valve surgery requires LIFE LONG TREATMENT.

NON MEDICAL MEASURES

-To break poverty---disease---poverty cycle improve living conditions such better housing.