Phys Clinical Cases · cardiovascular
Rheumatic Fever AND Rheumatic Heart Disease — DCE Clinical Case
DCE long-case and short-case station for Rheumatic Fever AND Rheumatic Heart Disease.
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Rheumatic Fever AND Rheumatic Heart Disease — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Rheumatic Fever AND Rheumatic Heart Disease. [1]
Presenting complaint: Subacute or acute symptoms referable to Rheumatic Fever AND Rheumatic Heart Disease, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References3ShowHide
- [1]Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography Circulation, 2015.PMID 25908771
- [2]Kumar RK, Antunes MJ, Beaton A, et al. Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap Circulation, 2020.PMID 33073615
- [3]Bray JJ, Thompson S, Seitler S, et al. Long-term antibiotic prophylaxis for prevention of rheumatic fever recurrence and progression to rheumatic heart disease Cochrane Database Syst Rev, 2024.PMID 39312290