Rheumatic Heart Disease: causes and treatment

Rheumatic heart disease is a condition in which rheumatic fever causes permanent damage to the heart valves. The heart valve is damaged by a disease that usually begins with a throat infection caused by a bacteria called streptococcus A, which could eventually produce rheumatic fever.

The effects of rheumatic fever:

  • Rheumatic fever, an inflammatory disease, can affect many connective tissues, especially those of the heart, joints, skin and brain.
  • Rheumatic fever can appear at any age, but it usually occurs in children five to 15 years of age.
  • Rheumatic fever causes heart damage – especially retractions of heart valves – forcing the heart to work harder to pump blood and may eventually produce congestive heart failure.

 

What are the symptoms of rheumatic fever?

The following are the most common symptoms of rheumatic fever. However, each individual may experience the symptoms in a different way. Symptoms, which vary greatly, typically begin one to six weeks after a strep throat infection, although occasionally the infection may have gone unnoticed as being very mild. Symptoms may include:

  • Fever.
  • Swollen, red, tender, and extremely painful joints, especially on the knees, ankles, elbows, or wrists.
  • Nodules on swollen joints.
  • Rash, reddish and reticular that usually appears on the chest, back and abdomen.
  • Uncontrolled movements of the arms, legs or facial muscles.
  • Weakness and shortness of breath.

The symptoms of rheumatic fever may resemble those of other bone disorders or medical problems. Consult your doctor for a diagnosis.

Treatment of rheumatic heart disease:

Specific treatment for rheumatic heart disease will be determined by your physician based on the following:

  • Your overall health and medical history.
  • How much the illness has progressed.
  • Your tolerance for certain medications, procedures or therapies.
  • Expectations for the course of the disease.
  • Your opinion or preference.

Since rheumatic fever is the cause of rheumatic heart disease, the best treatment is to prevent rheumatic fever from occurring. Penicillin and other antibiotics can usually treat throat infection (an infection of Streptococcus A bacteria) and prevent the development of acute rheumatic fever.

People who have previously contracted rheumatic fever are often given continuous antibiotic treatments (daily or monthly), possibly a lifetime, to prevent future attacks of rheumatic fever and reduce the risk of heart damage.

Antibiotic therapy has markedly reduced the incidence and mortality rate of rheumatic fever and rheumatic heart disease. To reduce inflammation, aspirin, steroids, or non-steroid medications may be given. Surgery may be needed to repair or replace the impaired valve.

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Expectations

The Rheumatic fever can cause serious heart problems and heart damage.

Possible complications

Long-term cardiac problems may occur, such as:

  • Damage to heart valves. This damage can cause a loss in the mitral valve or a narrowing that slows blood flow through the valve.
  • Damage to the heart muscle.
  • Heart failure .
  • Infection of the inner lining of the heart ( endocarditis ).
  • Inflammation of the membrane around the heart ( pericarditis ).
  • Heart rate that is fast and unstable .
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When to Contact a Medical Professional

Check with your provider if you or your child have symptoms of rheumatic fever. Because some other conditions have similar symptoms, you or your child will need careful medical evaluation.

If you have symptoms of strep throat, tell your provider. If you or your child have this disease, you will need evaluation and treatment. This will reduce the risk of developing rheumatic fever.

Prevention

The most important way to prevent rheumatic fever is to receive rapid treatment for strep throat and scarlet fever.

Alternative Names

Streptococcus – rheumatic fever; Streptococcal pharyngitis – rheumatic fever; Streptococcus pyogenes – rheumatic fever; Group A streptococcus – rheumatic fever

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References

Low ED. Nonpneumoccal streptococcal infections, rheumatic fever. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 372.

Shulman ST, Bisno AL. Nonsuppurative poststreptococcal sequelae: rheumatic fever and glomerulonephritis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 200.

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