Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever. An immune response causes an inflammatory condition in the body, which can result in on-going valve damage.
Rheumatic heart disease is caused by rheumatic fever, an inflammatory disease that can affect many connective tissues, especially in the heart, joints, skin, or brain. The heart valves can be inflamed and become scarred over time. This can result in narrowing or leaking of the heart valve, making it harder for the heart to function normally. This may take years to develop and can result in heart failure.
Rheumatic fever can occur at any age but usually occurs in children ages 5 to 15 years old. It’s rare in developed countries like the United States. Untreated or under-treated strep infections can increase the risk of rheumatic heart disease. Children who get repeated strep throat infections are at the most risk for rheumatic fever and rheumatic heart disease.
A recent history of strep infection or rheumatic fever is key to the diagnosis of rheumatic heart disease. Symptoms of rheumatic fever vary and typically begin 1 to 6 weeks after a bout of strep throat. In some cases, the infection may have been too mild to have been recognized, or it may be gone by the time the person sees a doctor.
These are the most common symptoms of rheumatic fever are fever, swollen, tender, red and excruciating painful joints — particularly the knees and ankles, nodules (lumps under the skin), red, raised, lattice-like rash, usually on the chest, back, and abdomen, shortness of breath and chest discomfort, uncontrolled movements of arms, legs, or facial muscles, and weakness. Symptoms of rheumatic heart disease depend on the degree of valve damage and may include shortness of breath (especially with activity or when lying down), chest pain and swelling.
Some complications of rheumatic heart disease include:
Heart failure-This can occur from either a severely narrowed or leaking heart valve.
Bacterial endocarditis-This is an infection of the inner lining of the heart and may occur when rheumatic fever has damaged the heart valves.
Complications of pregnancy and delivery due to heart damage-Women with rheumatic heart disease should discuss their condition with their healthcare provider before getting pregnant.
Ruptured heart valve-This is a medical emergency that must be treated with surgery to replace or repair the heart valve.
Rheumatic heart disease can be prevented by preventing strep infections or treating them with antibiotics when they do occur. It’s essential to take medicines as prescribed and to complete them as instructed, even if you feel better after a few days.
You will need to have an on-going follow-up with your healthcare provider to check the condition of your heart. Depending on the amount of heart damage, you may have some activity restrictions. Your healthcare provider may recommend that you take antibiotics for an extended period to prevent another infection of rheumatic fever.
Finding out you have rheumatic heart disease can be frightening. It is normal to feel worried about the diagnosis, anxious about the future or unsure about what to do next. There are lots of resources to support you to live with rheumatic heart disease and reduce the risk of complications.
Until Next Time,
Team Doctor ASKY!