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Dr. Andrew Rynne

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Does rheumatic heart disease cause rashes with wrist and ankle pain?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 5761 Questions

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Posted on Sat, 9 Jun 2018 in Hypertension and Heart Disease
Question: I believe I have or had strept throat about one week ago - headache, fever, body aches, sore throat with white patches on the tonsil and difficulty swallowing. About three to four days later I developed a rash on my torso, chest and back, about the level of the lower rib cage. One day ago I developed acute left wrist pain and now have developed right ankle pain and right wrist pain. My left wrist remains severely painful and limited in range of motion. My right wrist and right anke pain stiffness persist but on a lower grade level than my left wrist. Aside from the joint pain I would consider myself about 85% over my symptoms.
Does this sound like the possibility of rheumatic heart disease?
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your recent medical history and would explain that an acute rheumatic fever could not be excluded. You have had a suspicious throat infection followed by polyarhtritis, arthralgia and cutaneous rash (which should be carefully examined to confirm/exclude any presence of erythema marginatum and subcutaneous nodules giving such way more strong evidence of rheumatic fever).

Though rheumatic fever is usually encountered in pediatric age, isolated bouts in adults has been sporadically confirmed.

In order to exactly diagnose a possible streptococcal infection complication, such as rheumatic fever, first it is necessary to confirm the presence of strep infection by performing a microbiological throat culture and also antistreptolysin o (ASO) test.

Other markers of inflammation such as:

- complete blood count with leukocytes formula,
- PCR & ESR,
- complement titer

should be checked. A cardiac ultrasound is available to investigate a possible cardiac involvement (carditis).

At the end you should know that a strep infection when diagnosed early is completely and successfully treated without sequelae.

Hope to have been helpful to you!

You need to discuss with your doctor on the above mentioned issues.

Wishing you a Happy New Year!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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