Rheumatic Fever - Major and Minor Criteria

Rheumatic Fever - Major and Minor Criteria

Rheumatic fever occurs after a streptococcal infection (usually caused by Group A Beta-Hemolytic Strep (GABHS)).
It is an inflammatory condition that affects the joints, skin, heart and brain.

Major criteria are referred to as Jones criteria

J – Joint involvement which is usually migratory and inflammatory joint involvement that starts in the lower joints and ascends to upper joints

O – (“O” Looks like heart shape) – indicating that patients can develop myocarditis or inflammation of the heart

N – Nodules that are subcutaneous

E – Erythema marginatum which is a rash of ring-like lesions that can start in the trunk or arms. When joined with other rings, it can create a snake-like appearance

S – Sydenham chorea is a late feature which is characterized by jerky, uncontrollable, and purposeless movements resembling twitches

Minor criteria include

C – CRP Increased

A – Arthralgia

F – Fever

E – Elevated ESR

P – Prolonged PR Interval

A – Anamesis

L – Leukocytosis

Diagnosis of rheumatic fever is made after a strep infection (indicated by either throat cultures growing GABHS OR elevated anti-streptolysin O titers in the blood) and:

Two major criteria OR

One major criterion and two minor criteria

 

Related Questions Cardiology Medicine

Rheumatic fever occurs after a streptococcal infection (usually caused by Group A Beta-Hemolytic Strep (GABHS)).
It is an inflammatory condition that affects the joints, skin, heart and brain.

Major criteria are referred to as Jones criteria

J – Joint involvement which is usually migratory and inflammatory joint involvement that starts in the lower joints and ascends to upper joints

O – (“O” Looks like heart shape) – indicating that patients can develop myocarditis or inflammation of the heart

N – Nodules that are subcutaneous

E – Erythema marginatum which is a rash of ring-like lesions that can start in the trunk or arms. When joined with other rings, it can create a snake-like appearance

S – Sydenham chorea is a late feature which is characterized by jerky, uncontrollable, and purposeless movements resembling twitches

Minor criteria include

C – CRP Increased

A – Arthralgia

F – Fever

E – Elevated ESR

P – Prolonged PR Interval

A – Anamesis

L – Leukocytosis

Diagnosis of rheumatic fever is made after a strep infection (indicated by either throat cultures growing GABHS OR elevated anti-streptolysin O titers in the blood) and:

Two major criteria OR

One major criterion and two minor criteria

 

Constrictive Pericarditis

Etiology

- any cause of acute pericarditis may result in chronic pericarditis

Symptoms

- dyspnea, fatigue, palpitations
- abdominal pain

Signs

- general examination - mimics CHF (especially right-sided HF)
• ascites, hepatosplenomegaly, edema
- pulses: increased JVP, Kussmaul's sign (paradoxical increased in JVP with inspiration),
- Friedrich's sign (prominent “y” descent > “x” descent)
- pressures: BP normal to decreased, +/– pulsus paradoxus
- precordial examination: +/– pericardial knock (early diastolic sound)

Investigations

- 12 lead ECG: low voltage, flat T wave, +/– AF
- chest x-ray: pericardial calcification, effusions
- CT or MRI: pericardial thickening
- cardiac catheterization: equalization of RV and LV diastolic pressures, RVEDP > 1/3 of RV systolic pressure

Management

- medical: diuretics, salt restriction
- surgical: pericardiectomy