Rheumatism is a systemic inflammatory disease of connective tissue with predominant localization of the process in the cardiovascular system. The development of rheumatism is closely related to the previous acute or chronic nasopharyngeal infection caused by group A streptococcus, direct or indirect damaging effects of its components and toxins on the body with the development of immune inflammation.
Rheumatism is a fairly common disease that affects people of all age categories without exception. In children aged 5-15 years, rheumatism is an acute rheumatic fever that responds well to treatment with a relatively low risk of further complications. In older people, rheumatism is chronic, where in the vast majority of cases the main lesion is the heart.
Types of rheumatism
Rheumatism is a clinically complex disease with a fairly rich classification. The most common types of rheumatism are: rheumatic heart disease, polyarthritis, chorea, skin rheumatism and pneumatic pleurisy.
Treatment of rheumatism
The treatment of rheumatism is based on the early appointment of complex therapy aimed at suppressing streptococcal infection and the activity of the inflammatory process, as well as preventing the development or progression of heart disease.
The implementation of these programs is carried out according to the principle of stages:
- hospital treatment,
- aftercare in a local cardio-rheumatological sanatorium,
- dispensary observation in the clinic.
At stage I in the hospital, the patient is prescribed drug treatment, nutrition correction and physiotherapy exercises, which are determined individually, taking into account the characteristics of the disease and, above all, the severity of heart damage.
In connection with the streptococcal nature of rheumatism, treatment is carried out with penicillin.
- Antirheumatic therapy involves one of the non-steroidal anti-inflammatory drugs (NSAIDs), which is prescribed alone or in combination with hormones, depending on the indications.
- Antimicrobial therapy with penicillin is carried out for 10-14 days.
- In the presence of chronic tonsillitis, with frequent exacerbations of focal infection, the duration of treatment with penicillin is increased or another antibiotic is additionally used - amoxicillin, macrolides (azithromycin, roxithromycin, clarithromycin), cefuroxime axetil, other cephalosporins in an age dosage.
- NSAIDs are used for at least 1–1.5 months until the signs of process activity are eliminated.
- Prednisolone at the initial dose is prescribed for 10–14 days until the effect is obtained, then the daily dose is reduced by 2.5 mg every 5–7 days under the control of clinical and laboratory parameters, and subsequently the drug is canceled.
- The duration of treatment with quinoline drugs for rheumatism ranges from several months to 1–2 years or more, depending on the course of the disease.
In a hospital, chronic foci of infection are also eliminated, in particular, an operation to remove the tonsils, carried out 2–2.5 months from the onset of the disease in the absence of signs of process activity.
The main task at stage II is to achieve complete remission and restore the functional capacity of the cardiovascular system. In the sanatorium, the therapy started in the hospital is continued, foci of chronic infection are treated, an appropriate therapeutic regimen is carried out with differentiated physical activity, physiotherapy exercises, hardening procedures.
Stage III of the complex therapy of rheumatism provides for the prevention of relapses and progression of the disease. For this purpose, long-acting penicillin preparations are used, mainly Bicillin-5, the first administration of which is carried out during the period of inpatient treatment, and subsequently - 1 time in 2-4 weeks all year round. Regularly, 2 times a year, an outpatient examination is carried out, including laboratory and instrumental methods; prescribe the necessary health measures, physiotherapy exercises. In rheumatism without involvement of the heart, bicillin prophylaxis is carried out within 5 years after the last attack. In the spring-autumn period, along with the introduction of bicillin, a monthly course of NSAIDs is indicated.
Prognosis for rheumatism
The prognosis for rheumatism depends, first of all, on the timeliness of diagnosis and treatment. Since the formation of the most dangerous of the complications in rheumatism - heart disease, occurs in the acute phase, it is during this period that it is very important to undergo treatment with the necessary antibiotic.
Children and adolescents are most at risk, because it is at this age that the disease most often gives complications to the heart. In older people, there are predominantly articular or skin manifestations of rheumatism, in which the prognosis is more favorable. The number of relapses has a significant impact on the prognosis for rheumatism, so much attention should be paid to their prevention.
Prevention
Prevention of rheumatism is divided into primary and secondary.
Primary prevention is aimed at preventing rheumatism and includes:
- Increased immunity (hardening, alternating load and rest, good nutrition, etc.).
- Identification and treatment of acute and chronic streptococcal infections.
- Preventive measures in children predisposed to the development of rheumatism: from families in which there are cases of rheumatism or other rheumatic diseases; often sick with a nasopharyngeal infection; who have chronic tonsillitis or have had an acute streptococcal infection.
Secondary prevention is aimed at preventing relapses and progression of the disease in patients with rheumatism in the conditions of dispensary observation.
Rheumatism- inflammatory diseases of connective tissues, mainly in the cardiovascular and musculoskeletal systems.
Other names for the disease: Sokolsky-Buyo disease, Acute rheumatic fever.
Rheumatism ICD
ICD-10: M79.0
ICD-9: 729.0
Most often, rheumatism affects children and adolescents, aged 3 to 15 years.
The development of rheumatism provokes a nasopharyngeal infection - which, when it enters the body, activates immune antibodies, which in turn begin to attack streptococcus molecules. The entry of streptococcus into the body causes diseases such as, etc.
The problem is that somewhat similar molecules are found in the connective tissue of the heart and blood vessels of a person predisposed to rheumatism, and immune antibodies begin to attack them as well. Thus, an inflammatory process called rheumatism begins in the body.
To avoid rheumatism, it is necessary first of all to strengthen the immune system, and also to prevent various infectious diseases from going from acute to chronic.
Consider the signs of rheumatism.
Symptoms of rheumatism are expressed in:
Skin rheumatism. It is characterized by rheumatic nodules, annular or nodular erythema, small hemorrhages, sweating, pallor of the skin.
Rheumochorea (Dance of St. Vitus, rheumatism of the nervous system)- an inflammatory process inside the walls of small blood vessels in the brain. It is characterized by the manifestation of small cerebral vessels, motor restlessness, arrogant activity, discoordination in movement, muscle weakness, disorders in the musculoskeletal system, mental disorders (aggression, lethargy, absent-mindedness, etc.).
Rheumopleuritis (respiratory rheumatism). Characterized by chest pain, shortness of breath, fever, cough, pleural friction rub.
Rheumatism of the eyes. Is an integral part general manifestations of rheumatism of other organs. It is characterized by damage to the retina (retinitis) or other parts of the eye (iritis, iridocyclitis, etc.). Complications can be partial or complete loss of vision.
Rheumatism of the digestive organs. It is characterized by damage to the liver, kidneys and other organs of the gastrointestinal tract.
As already mentioned at the beginning of the article, the main cause of rheumatism is bacteria -. They can provoke the development of rheumatism:
Treatment of rheumatism is carried out in a complex and is based on the relief of streptococcal infection, strengthening the immune system, as well as the prevention of pathological processes of the cardiovascular system.
Treatment of rheumatism is carried out in three stages:
1. Treatment of the disease in the hospital
Inpatient treatment of rheumatism is aimed at stopping streptococcal infections, as well as restoring the functionality of the cardiovascular system. It includes:
- in the acute course of the disease, bed rest is prescribed;
- for the treatment of rheumatism is prescribed in a complex or separately, depending on the etiology of the disease, one drug from non-steroidal anti-inflammatory drugs (NSAIDs) and hormones;
- for complete relief of the disease, NSAIDs are used for 1 month or more;
- for 10-14 days, with drugs of the penicillin series ("Bicillin" conduct antimicrobial therapy;
- if the symptoms of rheumatism are often exacerbated or the disease is accompanied by other diseases caused by a streptococcal infection, for example, chronic tonsillitis, the period of treatment with penicillin increases, or another antibiotic is additionally prescribed: "", "Amoxicillin", "Clarithromycin", "Roxithromycin" , "Cefuroxime axetil", etc.
- "Prednisolone" is prescribed, in an individual dose, on the basis of laboratory tests, which is taken in the first 10 days at the initial dose, after which its intake is reduced every 5-7 days by 2.5 mg, and so on until the drug is completely discontinued;
- quinoline preparations are prescribed, which, depending on the course of the disease, are taken from 5 months to several years;
- in case of serious pathological processes in the throat area, the doctor may prescribe the removal of the tonsils.
2. Restoration of the immune and cardiovascular systems
Restoration of the immune and cardiovascular systems is prescribed to be carried out mainly in health centers (sanatoriums), in which:
- continue antirheumatic therapy;
- if they still remain, various chronic diseases are cured;
- prescribe a diet that includes, first of all, food enriched;
- prescribe hardening of the body;
- prescribe physiotherapy exercises.
3. Periodic doctor visits
Periodic visits to the doctor are carried out in the local clinic, which is aimed at preventing the remission of rheumatism, as well as the prevention of this disease.
In addition, at the 3rd stage of the treatment of rheumatism:
- continue to administer penicillin drugs in small doses (1 time in 2-4 weeks for 1 year);
– 2 times a year, instrumental and laboratory studies are carried out;
- prescribe special physiotherapy exercises;
- continue to strengthen the immune system with vitamins;
- 2 times a year, in spring and autumn, along with the use of penicillin, a monthly course of taking non-steroidal anti-inflammatory drugs is carried out.
- if the course of the disease was not associated with heart damage, for 5 years after the treatment of rheumatism, then they take penicillin preparations.
Important! Before using folk remedies, be sure to consult your doctor.
Propolis. Form a lozenge out of propolis, which is applied to sore spots during sleep. It is desirable to wrap the product with a scarf so that it remains warm.
Propolis compress. You can also grate propolis, then pour it with wine alcohol. Means to insist 10 days in a dark place, while shaking it daily. On the 11th day, cool the resulting tincture in the refrigerator for 10 hours and strain. The resulting product is used as compresses to the sore spot. From above, the compresses are wrapped with a woolen scarf to additionally warm the place. Only the remedy should be used carefully if damaged skin is present in the sore spot.
Propolis ointment. Propolis ointment has excellent analgesic, regenerative and anti-inflammatory properties. To prepare it, you need to heat up about 100 g of petroleum jelly, then cool it to 50 ° C and add 10 g of crushed propolis to it. The resulting mixture is put on the stove and cooked for another 10 minutes under a covered lid. Then the product is cooled, filtered through gauze, applied 2 times a day (morning and evening) to the affected areas.
Pine needles. Fill up completely liter jar May coniferous pine needles, then fill them with ordinary medical alcohol. Close the jar tightly with a lid and leave the product to infuse in a warm, dark place for 3 weeks, shaking it occasionally. After 3 weeks, strain the resulting remedy through cheesecloth and take 8 drops per sugar cube before meals 3 times a day for 4-6 months.
Birch leaves. Stuff the clothes in which you sleep with birch leaves. Cover well so you can sweat. So you need to sleep, but if you can’t fall asleep, then just sweat in the leaves for 3-4 hours, and you can remove them. Also great folk remedy birch baths serve for rheumatism. To do this, you need to fill (30-50%) the bathroom with birch leaves, let them steam, and then take a bath for 1 hour.
Aconite(be careful, aconite - poisonous plant). To prepare a tincture of aconite, you need to pour 50 g of crushed Jungar aconite into 500 g of vodka, then close the jar tightly with a lid and leave to infuse for 2 weeks in a dark place, periodically shaking the product. Then strain the product and store it in the refrigerator. Tincture, at night it is necessary to rub the sore spots, then wrap them with a flannel and tie them with a warm scarf. After removing the compress, wash the area with cold water.
Aconite tincture. 2.5-3 g of dry crushed aconite root pour 100 g of vodka. Put the product in a dark place for 2 weeks, shaking it occasionally. Then strain the remedy, and take 1 drop during a meal for 1 day. Then add 1 drop 3 times a day for 10 days, also during meals. On day 11, take 10 drops during 3 meals. From day 12, take one drop. The course of treatment is carried out 3 times, with a break of 5 days.
Decoction of aconite. Put 10 g of aconite root in a saucepan and pour 500 g of water into it. Boil the product for 2 hours over low heat. Then cool the product, strain, and rub it on the affected areas 3 times a day.
Omega 3. Omega-3 has excellent anti-inflammatory, restorative and analgesic properties not only for rheumatism, but also for arthritis, arthrosis and other diseases of the musculoskeletal and cardiovascular systems. In addition, Omega-3 is an excellent anti-aging agent.
Rheumatism is systemic inflammatory infectious-allergic predominantly disease heart and large joints. AT more rare cases involved in the pathological process also the nervous system, kidneys, skin and other organs. Synonyms of the disease: Sokolovsky-Buyo disease, in the acute period - rheumatic attack, rheumatic fever.
Cause, mechanisms of occurrence and pathogenesis of rheumatism
The factor provoking the occurrence of rheumatism is an infection caused by group A beta-hemolytic streptococcus. This pathogen initially causes throat diseases - tonsillitis, scarlet fever, pharyngitis, cervical lymphadenitis, erysipelas, and also releases specific toxins. The body responds to this by producing antibodies and immune responses. However, due to individual characteristics, the immune system of some people responds with the wrong reaction. As a result, the pathogen manages to “deceive” it, it begins to destroy the connective tissue of its own body - damage to the joints, heart, and other organs occurs.
Predisposing factors for rheumatism: hypothermia (especially in the autumn-spring period), young age, reduced immunity, large groups (schools, kindergartens, etc.), heredity. A polygenic type of inheritance has been established. The association of the disease with the inheritance of certain variants of haptoglobin, an alloantigen of B-lymphocytes, has been shown. The relationship with antigens HLA, A11, B35, DRs, DR7 was revealed. With damage to the heart valves, the frequency of carriage of HLA, A3 is increased, with damage to the aortic valve B15.
L. I. Benevolenskaya et al. identified a group of risk factors for the development of rheumatism, which is important for its prevention:
- the presence of rheumatism or diffuse diseases of the connective tissue, as well as congenital inferiority of the connective tissue in first-degree relatives;
- female;
- age 7-15 years;
- transferred acute streptococcal infection, frequent nasopharyngeal infections;
- carriage of the B-cell marker D8/17 In healthy individuals and, first of all, in relatives of the proband (→ the person from whom the study begins, in this case, the diseased person).
Modern science is considered to be toxic-immunological theory of the pathogenesis of rheumatism. Beta-hemolytic streptococcus produces biologically active substances that have a pronounced cardiotoxic effect and are able to suppress phagocytosis, damage lysosomal membranes, the main substance of connective tissue. There is a certain immunological relationship between streptococcal antigens and myocardial tissues. Streptococcus toxins cause the development of inflammation of the connective tissue, the cardiovascular system; the presence of an antigenic community between streptococcus and the heart leads to the inclusion of an autoimmune mechanism - the appearance of autoantibodies to the myocardium, antigenic components of connective tissue (structural glycoproteins, proteoglycans), antiphospholipid antibodies, the formation of immune complexes, aggravation of inflammation.
Symptoms of rheumatism
The onset is acute, about one to three weeks after the initial streptococcal infection, which is sometimes so mild that it may go unnoticed. Sometimes a rheumatic attack can begin within 1-2 days after a streptococcal infection against the background of
The usual initial symptoms of rheumatism are joint pains against the background of general weakness and increased, sometimes significantly (up to 40 ° C), temperature, which is accompanied by symptoms of intoxication - frequent pulse, chills, sweating, headache, weakness, malaise, lack of appetite, etc.. These symptoms can be either acute or initially inconspicuous, proceeding against the background of low temperature. In any case, gradually taking on a protracted character, sometimes increasing, these symptoms form the initial clinical picture of rheumatism, an obligatory part of which is rheumatoid arthritis.
Defeats joints, often symmetrical, with rheumatism they are “flying” in nature - sometimes one or the other joints hurt, mostly large (most often knee, elbow, ankle, wrist). At the same time, already at the beginning of the disease, lesions can be observed heart (rheumatic heart disease - myo-, endo-, pericarditis), which is manifested by pain in the region of the heart, cardiac arrhythmias, palpitations, symptoms of heart failure due to damage to the heart valves and the formation of defects.
Rarer symptoms of rheumatism include annular rash and rheumatic nodules.
Annular rash (erythema annulare) - pale pink rashes in the form of a thin annular rim, above the surface of the skin not rising, disappear when pressed. A rash is found in 7-10% of patients with rheumatism, mainly at the peak of the disease. It is usually unstable.
Subcutaneous rheumatoid nodules are round, dense, sedentary, painless, single or multiple formations with localization in the area of large and medium joints, spinous processes of the vertebrae, in tendons. Currently, they are rare, mainly in severe rheumatism, persisting from several days to 1-2 months.
Damage symptoms nervous systems for rheumatism are even less common. They can also occur at the very beginning of the disease, but usually occur after some time. time (1-2 months after a streptococcal infection). Neurorheumatism or rheumatic encephalitis manifests itself in the form of a small chorea (Sydenham's chorea) - erratic bizarre movements and muscle contractions along with a decrease in muscle tone. It occurs more often in girls and young girls.
Rheumatic lesions kidneys (glomeruli), digestive and other systems are now almost never found, which is associated with a large percentage of early detection and timely treatment. However, the appearance of symptoms signaling the involvement of these organs in the pathological process is quite possible.
Diagnosis of rheumatism
The diagnosis of rheumatism is made taking into account the data of the clinical picture and laboratory tests. A general blood test, leukoformula test, rheumatic tests are needed. Nonspecific signs of inflammation are found in the blood: C-reactive protein, accelerated ESR, neutrophilic leukocytosis, thrombocytosis.
Laboratory tests can reveal elevated levels of antibodies in the body. Thus, high titers in the antistreptolysin test (ASLO) indicate the production of antibodies against streptolysin O (an exotoxin of β-hemolytic streptococcus group A) in the body. Antistreptolysin antibodies remain in the body for 4-6 weeks after exposure to GAS bacteria. An increase in titers of antistreptococcal antibodies is characteristic: antistreptohyaluronidase and antistreptokinase more than 1:300, antistreptolysin more than 1:250. The height of titers of antistreptococcal antibodies and their dynamics do not reflect the degree of activity of rheumatism. In addition, many patients chronic forms rheumatism signs of participation of streptococcal infection are not observed at all.
In swabs from the nasopharynx and oropharynx, β-hemolytic streptococcus group A is sown.
Differentiate rheumatism, and in particular rheumatoid arthritis, follows from other joint diseases, such as rheumatoid arthritis. Although their names are similar, they are different diseases. In rheumatoid arthritis, mainly large joints are affected, their lesions are asymmetrical, joint pains are of a “volatile” nature. In contrast, with rheumatoid arthritis, symmetrical small joints are more affected, and the pain in them is persistent. Involvement of other organs in rheumatoid arthritis is rare.
Also follows differentiate rheumatism with infectious-allergic polyarthritis and with other polyarthritis. Onset at the age of 7-14 years, concomitant lesions of other organs and data from rheumatic tests allow differentiate diagnosis of rheumatic fever.
Treatment and prevention of rheumatism
The treatment of rheumatism is a rather complex, lengthy and persistent process.
It must be carried out by a rheumatologist. For the treatment of rheumatism, a three-stage system is used:
Stage I - in active phase diseases - long-term (4-6 weeks) treatment in a hospital;
Stage II - post-hospital sanatorium treatment (resorts of Kislovodsk, Southern coast of Crimea);
Stage III - preventive treatment and observation by a rheumatologist at the place of residence.
The main groups of drugs used in the treatment of rheumatism are as follows:
- Antibiotics, mainly penicillin and its derivatives;
- NSAIDs: diclofenac, ibuprofen, naproxen, etc.;
- Glucocorticoids: prednisolone, methylprednisolone, dexamethasone, etc.;
- Immunosuppressants (plaquenil, delagil, imuran);
- γ-globulins;
- Vitamins (mainly C, sometimes B12 and others).
Be sure to identify and sanitize inflammatory foci (tonsils, carious teeth, sinusitis, etc.).
AT rehabilitation period may apply chondroprotectors, as well as physiotherapy, ultraviolet, electrophoresis medicines, heating with a solar lamp or an infrared lamp, UHF, paraffin applications.
In the active phase of the rheumatic process, in order to improve blood circulation, eliminate the consequences of immobility, it is recommended to massage the limbs. Also, the complex of therapeutic measures necessarily include physiotherapy exercises. The specific choice of drugs and procedures, their combinations and dosing are always determined by the attending physician individually. Treatment of rheumatism, in addition to active therapy in the acute period, includes long-term prevention of relapses (dispensary registration, taking NSAIDs, hardening, sanitation of inflammatory foci).
Prognosis for rheumatism
Early treatment eliminates the immediate threat to life. However, rheumatic attack in childhood and continuously recurrent rheumatic heart disease lead to the formation of heart defects and the development of heart failure.
With rheumatism, damage to organs and systems occurs. This is the main danger and insidiousness of the disease. Rheumatism often affects the cardiovascular system. This leads to development.
Rheumatism leads to damage to the joints. Arthritis can be acute or subacute. Hence development is appropriate. But its development occurs after the infectious process, within ten, fourteen days.
Often, with rheumatism, the patient's skin is affected. At the same time there are rheumatic nodules in the form of rounded seals. Mainly on the skin of the legs, in the area of the knee joints. There is also damage to the nervous system and internal organs.
What it is?
Rheumatism is a systemic lesion of the human body, with pathological phenomena occurring. The infectious process matters. It is the infection that often contributes to the development of rheumatism.
Heart damage is detected in the form of focal or diffuse myocarditis. Moreover, the phenomena of inflammation of the inner lining of the heart are frequent. And also develops and pancarditis.
Systemic lesion in rheumatism is characterized by damage to internal organs. And the phenomena concerning all organism of the patient develop. The following organs and systems are involved in rheumatism:
- pleura (hence rheumatic pleurisy);
- peritonitis (inflammation of the peritoneum);
- lungs (focal pneumonia);
- kidneys ();
- liver ().
In addition, damage to other organs can also be noted. However, the above organs and systems are often affected. As evidenced by the systemic disease itself.
Causes
What are the main causes of rheumatism? Infections are the main etiological factors. Moreover, infections that for a long time did not respond to adequate treatment. The predominant causative agent of rheumatism is streptococcal infection.
Streptococcal infection causes various diseases. So, the following diseases are among the possible causes of rheumatism:
- tonsillitis;
- pharyngitis.
Allergic reactions of the body matter. In response to a penetrating infection, reactions occur from the body. In addition, immune reactions can be the causes of rheumatism. With their weakening, the development of the disease occurs.
Cooling down and mental trauma play an important role. All these factors together contribute to the development of rheumatism. Immunity is reduced, an unfavorable factor affects.
Symptoms
Depending on the lesions, the symptoms of rheumatism are distinguished. The most common symptoms of heart failure are:
- intermittent palpitations;
- pain and discomfort in the heart;
- violation of the heart rhythm;
- weakness;
- fatigue.
In some cases, if the heart is affected, there are no symptoms. Only with a diagnostic technique is a violation of the rhythm detected. Subfebrile body temperature and changes in the blood are also noted.
If diffuse myocarditis is involved in the process of heart damage, then the symptoms are most severe. The patient may complain of the following symptomatic signs:
- dyspnea;
- constant heartbeat;
- severe weakness;
- fainting states.
In addition, patients have a certain appearance. Patients are pale, revealed cyanosis, edema and congestion in the liver and lungs. The heart sounds are muffled, the pulse is frequent, soft, arrhythmic.
With the phenomena of endocarditis, patients complain of malaise, weakness, palpitations, discomfort in the heart. With symptoms of pericarditis, patients feel shortness of breath, weakness and dizziness. This raises the body temperature. If pancarditis occurs, then a particularly serious condition of the patient is noted.
When the joints are affected, pain in them, swelling, redness of the skin and impaired motor function are noted. The patient's condition is the most severe. When the skin is damaged, the following symptoms are noted:
- skin redness;
- hemorrhages;
- increased vascular permeability.
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Diagnostics
How can rheumatism be diagnosed? Diagnosis of rheumatism includes the collection of the necessary information. including clarifying possible causes. The hereditary history matters.
In diagnostics, methods of objective and subjective research are used. Including the patient's complaints are investigated. The patient often complains about his condition. But it is also necessary to carry out the following studies:
- laboratory research;
- electrocardiography;
- radiography;
- ultrasound diagnostics.
Laboratory tests include blood and urine tests. In the blood there is leukocytosis, accelerated ROE. Leukocytosis is indicative of inflammatory process. It is also appropriate to measure the pulse.
There is also a change in the blood formula. Especially with the phenomena of pericarditis. Ultrasound diagnostics can detect changes in the liver and kidneys. Also, with the phenomena of pleurisy, it is possible to conduct x-rays.
Radiography is used for pathological changes in the lungs. It is highly advisable to use auscultation of cardiac activity. This reveals:
- muffled heart sounds;
- weakened heart sounds.
Electrocardiography shows arrhythmias. Quite often tachycardia comes to light. That is an increase in heart rate.
When diagnosing, pay attention to external signs rheumatism. Including discomfort in the heart. An echocardiogram is also an additional diagnostic method. In this case, a defect in the heart valve is detected, the risk of developing heart disease.
Diagnosis is based on a consultation with a neurologist. Consultation with a neurologist is appropriate for nervous disorders. As nervous system also suffers from rheumatism. The consultation also applies to the following professionals:
- nephrologist;
- therapist;
- cardiologist.
Prevention
Can rheumatic fever be prevented? Of course you can. For this, the elimination of the main cause of rheumatism is very effective. Infectious diseases should be cured in time. It is very necessary to strengthen the immune system. 
You can strengthen the immune system with the help of systematic hardening. Physical training is widely used in the prevention of rheumatism. What diseases should be given more attention? Treatment is necessary in the following cases:
- with symptoms of tonsillitis;
- with sinusitis;
- with dental granulomas.
Prevention is aimed at medical examination. This is especially true for schoolchildren with chronic infections. Their elimination helps to reduce the risk of developing rheumatism.
To strengthen immunity, it is also necessary to adhere to some rules. These rules are aimed at the following activities:
- introduction of a healthy lifestyle;
- proper nutrition;
- the use of vitamins and minerals;
- dietary compliance.
The introduction of a healthy lifestyle is a major component of a strong immune system. And taking vitamins reduces the risk of developing infectious diseases. Proper nutrition promotes the establishment of the process of digestion, helps to improve the intestinal microflora. After all, the gut is responsible for the immune response!
Treatment
Treatment of rheumatism should be comprehensive. It consists of three stages of therapeutic therapy. The emphasis is on inpatient treatment. It also includes the following three steps:
- sanatorium treatment;
- dispensary observation.
Sanatorium treatment includes rest in places of rehabilitation after discharge from the hospital. Dispensary observation eliminates the risk of re-detection of rheumatism. Clinical examination is necessary for the further development and prevention of pathological phenomena, including to exclude complications.
Drugs are also used in the treatment of rheumatism. Among the drugs, preference is given to the following drugs:
- aspirin;
- salicylic sodium;
- pyramidon.
However, the course of the disease matters. For example, in the acute course of rheumatism, the following dosage is used:
- aspirin 4-5 grams per day;
- salicylic sodium 8-12 grams per day;
- pyramidon 2-3 times a day.
This dosage is used at the time of acute development of the disease. The necessary conditions for stopping the administration of this dosage are the acute phase of the course of the disease, the normalization of body temperature. As well as the normalization of blood.
Anti-inflammatory agents are also used. These funds include:
- butadione;
- hormones.
Among hormonal agents, cortisone, prednisolone, ACTH are used. But a prerequisite is medical supervision. In cases with spa treatment, preference is given to southern shores Crimea, Odessa, Evpatoria, Sochi. However, it is important to resort to spa treatment after a certain time, from the beginning of the acute period.
In adults
Rheumatism in adults has a number of features. In its development, the age of the patient matters. Rheumatism is more often diagnosed in young people. Rheumatism is more common in women than in men.
In adults, the disease can be caused by hereditary predisposition. Rheumatism in adults may not appear immediately. Usually, after a certain time, under the influence of adverse factors, rheumatism begins to remind itself. After a banal hypothermia, signs of rheumatism come to light in two days.
Rheumatism in adults tends to relapse. These relapses occur after the disease. Surgery can also be a predisposing factor. After surgery, immunity decreases and this leads to rheumatism.
There are some types of rheumatism in adults. The following types of rheumatism are predominantly relevant:
- articular rheumatism;
- rheumatic heart disease;
- skin rheumatism;
- pleurisy, rheumatic;
- pericarditis.
There are also certain clinical signs in adults. Most often, the clinic for rheumatism is as follows:
- fever;
- sweating;
- joint pain.
The most severe manifestation of the disease in adults is rheumatic heart disease. In this case, the process covers the myocardium and the membranes of the heart. Patients have:
- intoxication;
- stabbing pain;
- tachycardia;
- lowering blood pressure.
A complication of this type of myocarditis in adults is heart failure. From this, a certain symptomatology arises, which is characterized by signs indicating the development of heart failure. These features are based on:
- dyspnea;
- arrhythmia;
- swelling of the legs;
- darkening in the eyes;
- liver enlargement.
In children
Rheumatism in children is not uncommon. He is associated with various diseases. Including infectious diseases. Hereditary predisposition also matters.
In children, the heart muscle is also affected. The following symptoms are typical:
- acute inflammation of the myocardium;
- dyspnea;
- heart pain;
- tachycardia;
- pallor of the skin;
- swelling of the veins of the neck.
The causative agent of infectious diseases in children is streptococcus. If the infection is not treated properly, then rheumatism occurs in children. This infection should be treated with antibiotics.
Colds are at the highest risk for rheumatic fever. If a child often suffers from colds, then rheumatism occurs with the greatest risk. The following are also predisposing factors:
- overwork (mainly at school age);
- malnutrition;
- hypothermia.
Children between the ages of eight and sixteen are most susceptible to rheumatism. Symptoms of rheumatic fever in children include:
- myocarditis;
- pericarditis;
- dyspnea;
- increased fatigue;
- joint pain;
- nervous disorders.
In the latter cases, nervous disorders affect mostly girls. In this case, voluntary movements are possible, which are amplified with emotions. It is necessary to prevent the development of this pathology in time.
Forecast
With rheumatism, the prognosis depends on the underlying pathology. In this case, it is an infection. For example, a streptococcal infection. Its development should be prevented in time.
The prognosis largely depends on the presence of complications. If the complications are the most severe, then the prognosis is the worst. Modern methods of treatment can prevent relapses.
If all the membranes of the heart muscle are affected, then complications cannot be avoided. In this case, we can talk about the severity of the pathological process. The prognosis is unfavorable.
Exodus
Rheumatism can result in heart failure. In this case, it is almost impossible to avoid serious consequences. In the wake of heart failure, heart disease occurs.
With heart disease, mortality is possible. But modern methods medical therapy has learned to cope even with this formidable phenomenon. by the most dangerous phenomenon appears to be an obliterated form of the disease.
An erased form of the disease is predicted in children. Its outcome is lethality and all kinds of complications. Since for a favorable outcome, timely diagnosis and treatment are necessary.
Lifespan
In the case of rheumatism, life expectancy is this moment does not change. It is not affected by the course of the disease. However, there are exceptions.
If it was not possible to eliminate the infectious disease, then rheumatism manifests itself in a rather severe course. With repeated relapses and complications. To prevent them, it is necessary to carry out appropriate treatment.
Treatment of rheumatism should be comprehensive. If all treatment options are involved in the treatment process, including rehabilitation and recovery, then the patient's life expectancy increases. So the quality is getting better!
