TREATMENT PLAN, PROGNOSIS, KEY INFORMATION & EXTRA’S
TREATMENT PLAN
Acute management:
- Specialist referral required Bed rest
Penicillin
- Symptomatic control
Secondary prevention:
- Penicillin/sulfadiazine for ≥5 years
- If no cardiac involvement: continue for 5 years
- If cardiac involvement: continue until age 25 or longer
PROGNOSIS
Risk of:
- Recurrence with further streptococcal infections
- Infective endocarditis
- Heart valve damage
KEY INFORMATION
- Requires specialist referral
- Secondary prophylaxis duration depends on cardiac involvement
- Echo is essential for diagnosis
- Major complication: heart valve damage
EXTRA’S
Related conditions:
Myocarditis:
- Inflammation of the myocardium
- Similar to MI presentation/palpitations
- Main cause: viral (Coxsackie virus)
- Requires cardiology admission
- Treatment: supportive care
Pericarditis:
- Sharp constant sternal chest pain
- Pain worse: lying on left side, inspiration, swallowing, coughing
- Pain relief: sitting forward
- Radiation: left shoulder, arm, abdomen
- Signs: pericardial rub at left sternal edge
- Causes: infections (Coxsackie virus, TB), malignancy, uraemia, post-MI (Dressler’s syndrome), trauma, radiotherapy, connective tissue diseases, hypothyroidism
- ECG: concave saddle-shaped ST elevation in all leads
- Complications: pericardial effusion, cardiac tamponade, constrictive pericarditis
- Management: symptomatic support, cardiology referral
- Echo: diagnostic for complications.