Understanding Rheumatic Fever: Jones Criteria and Aortic Regurgitation Explained

Understanding Rheumatic Fever: Jones Criteria and Aortic Regurgitation Explained

Question 1. Enumerate the causes of Jones criteria of acute rheumatic fever.

Answer. The causes of Jones criteria are:

1. Previous streptococcal infection
2. Recent scarlet fever
3. Positive throat culture from streptococcal A
4. Increased-antistreptolysin O titer.

Question 2. Describe briefly clinical features and management of aortic regurgitation.

Answer. Aortic regurgitation is produced due to acute rheumatic carditis which is associated with other valve involvement and infective endocarditis.

Clinical Features Rheumatic Mitral Stenosis.

Symptoms Rheumatic Mitral Stenosis.

1. In mild to moderate aortic regurgitation:

1. Often asymptomatic
2. On palpitation — pounding of heart is a common symptom
3. Symptoms of left heart failure appear but late

2. In severe aortic regurgitation:

1. Symptoms of heart failure, i.e., dyspnea, orthopnea are present at onset.
2. Angina pectoris is frequent complaint.
3. Arrhythmias are uncommon.

Understanding Rheumatic Fever: Jones Criteria and Aortic Regurgitation

Signs Rheumatic Mitral Stenosis.

1. Collapsing or good volume pulse (wide pulse pressure)
2. Bounding peripheral pulses
3. Dancing carotids (Corrigan’s sign)
4. Capillary pulsation in nail beds (Quincke’s sign)
5. Pistol shots sound and Duroziez’s sign/murmur
6. Head nodding with carotid pulse — de Musset’s sign
7. Cyanosis (peripheral, central or both) may be present
8. Pittng ankle edema may be present.
9. Tender hepatomegaly if right heart failure present.

Jones Criteria for Rheumatic Fever and Aortic Regurgitation

Management Rheumatic Mitral Stenosis.

1. Treatment of underlying causes like endocarditis and syphilis.
2. Surgical: Replacement of aortic valve should be performed before heart failure can develop.
   Serial evaluation of end systolic dimensions should be made and surgery considered when this exceeds 5 mm.
3. Medical:

1. Prophylaxis against bacterial endocarditis before and after surgery
2. Therapy of heart failure if develops