Rheumatic fever

The most crucial advice for patients is the importance of adhering to secondary prophylaxis. A first attack not involving the heart does not necessarily mean that subsequent attacks will also spare the heart.​​​[64]Carapetis JR, Currie BJ. Rheumatic fever in a high incidence population: the importance of monoarthritis and low grade fever. Arch Dis Child. 2001 Sep;85(3):223-7. https://adc.bmj.com/content/85/3/223.long http://www.ncbi.nlm.nih.gov/pubmed/11517105?tool=bestpractice.com ​ This should include education about rheumatic fever and rheumatic heart disease, underlining the importance of treating sore throats early and recommending a nonpenicillin antibiotic for streptococcal pharyngitis if the patient is taking penicillin prophylaxis.

Oral health is very important in these patients and patients should receive education about dental care. Patients with carditis should be encouraged to inform their doctor or dentist prior to any interventional procedure so appropriate antibiotic prophylaxis against infective endocarditis can be given.