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What is rheumatic heart disease?
Rheumatic heart disease is a condition in which the heart valves (flap-like structures which prevent the blood from flowing backwards) are damaged by a disease process that begins with a throat infection caused by the streptococcal bacteria. If not treated this throat infection leads to rheumatic fever, repeated episodes of which may cause rheumatic heart disease.
Rheumatic fever is an inflammatory disease that affects the connective tissues of the body-especially those of the heart, the joints, the brain or the skin. When rheumatic fever permanently damages the heart, the condition is called rheumatic heart disease.
People of all ages can suffer from acute rheumatic fever, but it usually occurs in children five to fifteen years old. -
What are the symptoms of rheumatic fever?
They are:
- Fever
- Swollen, tender, red and painful joints-particularly the knees, ankles, elbows, or wrists
- Nodules or lumps over swollen joints
- Uncontrolled movements of arms, legs, or muscles of the face
- Weakness and shortness of breath.
- Fever
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What are the symptoms of rheumatic heart disease?
The symptoms may vary from person to person. Some people face no problems for years, while others may feel mild discomfort throughout their lives. Eventually damaged and scarred heart valves can cause serious and disabling problems. These problems depend on the severity of the damage and on which heart valve is affected. Abnormalities of valves on the left side of the heart (the mitral and the aortic valves) usually cause symptoms earlier than abnormalities on the right side (the tricuspid and the pulmonary valves).
The heart becomes overactive during vigorous work or play, or during emotional excitement. Dizziness or fainting during exertion, shortness of breath, fatigue and palpitations are the other symptoms. -
What happens when a heart valve is damaged?
A damaged heart valve either does not completely close (insufficiency) or does not completely open (stenosis).
A heart valve that does not close properly, allows blood leak back into the chamber from which it was pumped. This is called regurgitation or leakage. With the next heartbeat, this blood flows through the valve and mixes with blood that flows normally. This extra volume of blood passing through the heart puts added strain to the heart muscle.
When a heart valve doesn’t open enough, the heart must pump harder than the normal to force blood through the narrowed opening. Usually there are no symptoms of this until the opening becomes very narrow. -
How is it diagnosed?
A chest X-ray and an electrocardiogram are two tests commonly used to determine if the heart has been affected.
Echocardiography is a technique that sends sound waves into the chest to rebound from the heart’s valves and walls. The recorded waves show the shape, texture and movement of the valves. It also shows the size and functioning of the heart chambers. This technique doesn’t hurt or pose a risk to patient. -
What is the treatment?
The doctor determines the specific treatment based on the overall health, medical history, and the extent of the disease.
Since rheumatic fever is the cause of the heart disease, the best treatment is to prevent rheumatic fever from occurring. Penicillin and other antibiotics can usually treat strep throat (a streptococcus A bacteria infection). Patients who have previously suffered from rheumatic fever are often given continuous (daily or monthly) antibiotic treatments, possibly for life, to prevent future attacks of rheumatic fever and lower the risk of heart damage.
In severe cases of heart valve damage, valve replacement surgery may be recommended. In such a surgery the damaged heart valve is replaced with an artificial valve made of metal or plastic, or with a specially prepared valve from an animal such as pig. Most patients improve markedly after the replacement surgery. -
How can it be prevented?
The best prevention against rheumatic heart disease is to prevent rheumatic fever. This can usually be accomplished by prompt and adequate treatment of throat infection. If rheumatic fever develops, continuous antibiotic treatment may be needed to prevent further attacks.
