SAY ni DOK | Sanhi, sintomas at kung paano maiiwasan at magagamot ang rheumatic heart disease
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00:00 According to the 2020 data released by the World Health Organization,
00:04 1,807 people in the Philippines died from rheumatic heart disease.
00:12 And that's why this morning, here in CineDoc,
00:14 we will be given a free telemedicine about this disease.
00:18 We will be joined by Dr. Ronald Cuyco,
00:21 the President of the Philippine Heart Association or PHA.
00:24 Dr. Ronald, good morning. Welcome to Rise and Shine Philippines.
00:27 Good morning.
00:28 Good morning, Deanne and good morning, Audrey.
00:31 Thank you for inviting us here to talk about this important heart disease, rheumatic heart disease.
00:38 For everyone's knowledge, what is rheumatic heart disease and what is its cause?
00:48 Okay.
00:48 Rheumatic heart disease, when you say rheumatic, it means inflammation.
00:54 So, if you say rheumatic heart disease, therefore, this is the cause of heart failure, especially the pulmonary valve.
01:03 Now, this happens because of infection in the pulmonary or sore throat or infection in the skin.
01:11 So, if this is repeated and not treated, it will lead to a peck clot in the pulmonary valve.
01:20 Oh, okay.
01:21 So, when it's a peck clot, the edges of the pulmonary valve can retract, it can expand, or it can tighten.
01:29 So, that's when the patient has symptoms.
01:31 If the pulmonary valve is tight, the blood in the heart cannot flow easily.
01:36 Is it correct that from sore throat, you will have this disease that will affect the heart?
01:41 That's right, Deanne.
01:42 That's why it's very important for us to protect the sore throat.
01:45 Let's not neglect it.
01:46 Because when there's an infection in the sore throat, there's an inflammation, a sort of immune-mediated reaction
01:53 that goes to the pulmonary valve.
01:56 Others go to the joints, that's why we call it arthritis.
02:01 In the first peck, for example, when there's a sore throat or skin infection,
02:06 the patient can have a fever, have arthritis, and eventually, the heart will be involved.
02:13 We call that a rheumatic fever.
02:15 That's the initial stage that we need to protect.
02:19 We need to detect rheumatic fever well because there's a medicine that can prevent rheumatic heart disease.
02:27 Okay. Is rheumatic heart disease true that it takes a long time,
02:31 or it takes a few years before the symptoms show up?
02:36 That's right, Deanne.
02:37 That's right, Audrey.
02:38 It means that it's a cycle.
02:41 The process is that there needs to be a peck lock on the valve.
02:46 So, like I said earlier, if there's a rheumatic fever, it needs to be protected.
02:50 If it's repeated, that's where the peck lock is.
02:54 So, it takes years, sometimes 10 years, 20 years, before the patient shows symptoms.
03:00 This is when there's palpitations, sore throat, difficulty breathing,
03:04 and towards the end, they'll have a fever.
03:08 So, these are the symptoms of a patient who has rheumatic heart disease.
03:15 So, it takes a long time, Deanne.
03:17 So, 10 to 20 years before the symptoms show up.
03:23 But, Doc, what about this medicine?
03:25 What's the procedure or diagnosis?
03:27 What's the procedure for a person with rheumatic heart disease?
03:32 Yes, Audrey. We need to emphasize to our fellow citizens
03:36 that the first step is, if you feel something, especially in young people,
03:42 because this is common in young people, 20 years old, 30, 40, 50,
03:46 if you feel something, we need to consult a doctor first.
03:52 The first thing you consult with a doctor is to listen to the doctor's heart.
03:57 We call it an auscultation of a stethoscope.
04:00 They can hear if there's a problem with the valve.
04:02 We call it a murmur, abnormal heart sound.
04:05 That's when the tests that the doctor will do will be done.
04:09 You'll be given an X-ray at the ECG.
04:11 But the definitive test, for our fellow citizens,
04:15 for RSP, the definitive test really is 2D echo with Doppler studies.
04:22 So, we need this particular test or procedure
04:26 to know that you really have a rheumatic heart disease.
04:30 How frequent should we have 2D echo?
04:33 Is it yearly to check that our heart is still healthy?
04:39 Related to rheumatic heart disease, it's not something you can do easily.
04:43 You really need to have a request from the doctor.
04:47 You need to have an exam from the doctor first.
04:48 If they hear abnormalities in your heart sound,
04:52 that's when you'll do 2D echo.
04:53 But I want to emphasize this.
04:56 There's a program now, especially in the government.
04:59 There's a government program, DOH with PhilHealth.
05:02 PhilHealth has a free 2D echo coverage
05:07 and it's medicine is penicillin.
05:09 So, we just need to get the hospitals to give us credit
05:14 to cover this.
05:15 So, we have a good program
05:18 in coordination, of course, with our
05:22 government and then private sector like Philippine Heart Association.
05:25 So, we already have this PhilHealth coverage.
05:28 So, if you look at it, 2D echo can be helped.
05:31 Even for those who are suffering.
05:33 If you already have rheumatic heart disease,
05:38 how can we treat it?
05:40 First of all, as I said in the first episode,
05:44 rheumatic fever, with fever, joint pains,
05:47 abnormal sounds, heart.
05:50 Sometimes, we need to give penicillin.
05:54 Penicillin is a cheap medicine but it's very effective
05:58 to prevent the progression of the disease
06:02 in the case of pectoralis in the valve.
06:04 So, again, we really need to be quick
06:09 to identify the first outbreak of rheumatic fever.
06:13 And then, even if they already have a problem with the valve,
06:17 we still give their medicine, penicillin.
06:21 Sometimes, it takes like 10 years.
06:24 From the time of the first outbreak of rheumatic fever,
06:27 they've been taking penicillin for 10 years.
06:29 Now, towards the end, if the other medicine
06:32 in the heart doesn't work, related to rheumatic heart disease,
06:38 the last thing is an operation.
06:40 Change the valve.
06:42 If it's not tight, we do something here.
06:44 We call it transcatheter bulbotomy.
06:47 We insert a catheter here in the valve
06:49 to the valve that we enlarge.
06:54 Doc, can there be other complications of an individual
06:58 if they have been left out of rheumatic heart disease?
07:01 Yes, of course.
07:02 Of course, like other diseases,
07:07 if you leave them out, they get worse and worse.
07:09 So, early intervention detection is needed.
07:12 One of the complications is that the patient has difficulty breathing
07:18 because there's water in the lungs,
07:20 and they get arrhythmias, and sometimes,
07:24 it can be the cause of death if left out.
07:29 Well, Doc, it's the month of February.
07:32 Of course, it's National Heart Month.
07:35 Are there activities and programs
07:37 prepared by the Philippine Heart Association?
07:40 Thank you, Dr. for the reminder.
07:42 This month, we will be having our Heart Month celebration
07:46 in the whole Philippines,
07:47 as far as the Philippine Heart Association.
07:49 This time, the celebration will be in Zamboanga.
07:53 So, we will be in Zamboanga to celebrate the Heart Month.
07:57 But in the whole Philippines,
07:59 as far as the Philippine Heart Association is concerned,
08:02 every chapter, every province,
08:04 will have a Philippine Heart Month celebration
08:08 to promote the advocacy of the Philippine Heart Association.
08:13 So, this is not just a month of love,
08:16 it's also a month of heart.
08:18 Yes, of caring for our hearts.
08:20 So, we will be one of the activities
08:23 led by the Philippine Heart Association.
08:25 Well, Dr. Ron Edcoco, thank you very much
08:27 for visiting Rise and Shine Philippines
08:30 and for giving us free telemedicine for our hearts.
08:33 Thank you, Dr. Edcoco.
08:34 Thank you, Deanne. Thank you, Audrey.