Q: I suffered from an attack of Rheumatic Fever about 6 months back. I was admitted in the hospital for about 15 days. There I was given Procain Penicilin injections (6 Lac Units) everyday for a period of 10 days. After that I am continuing with penidure injection (12 Lac Units) every 21 days. While I was admitted the ECG and Echocardiogram did not report any damage to the heart valves. After about 3 months, the pain in the joints continued. I got another blood test done (ASO titre and C-Protein) C-Protein was negative while ASO did show some increase in the level. My problem is that sometimes I still feel some pain in the chest region (around the heart). Although, I do not feel any exhaustion while walking or climbing stairs. How can I be sure whether there is no damage to the heart? What tests to be done? How long do I have to take penidure injection? What if I have to go abroad to Europe or US? Will procuring an Injection there will be a problem?

A:You can be sure whether there is any damage to your heart by getting an echo done. But it is important to comprehend that the time gap between an episode of rheumatic fever to damage to the heart producing clinical valve disease can take as early as 6 months or can be as late as 20 years. So an echo for you at this juncture is useless, but regular follow up with a cardiologist is mandatory. Regarding how long you need to take medicine depends on many factors, including a detailed clinical examination. So it will be impossible for me to comment. Many oral medicines are available that can replace Penidure, when you are on a trip abroad. The drug is however available in US & UK, about other European nations I have no first hand information.