Rheumatic Heart Disease

Rheumatic heart disease (RHD) is a chronic and potentially debilitating condition that occurs when the heart valves are damaged due to rheumatic fever, an inflammatory disease that can occur after an infection with group A Streptococcus bacteria.

What is Rheumatic Fever?

Rheumatic fever is an autoimmune response to a streptococcal infection, such as strep throat or scarlet fever. The immune system mistakenly attacks the heart valves, leading to inflammation and scarring. If left untreated, rheumatic fever can cause permanent damage to the heart valves.

Symptoms of Rheumatic Heart Disease

The symptoms of RHD may not appear until years after the initial infection with rheumatic fever. Common symptoms include:

• Shortness of breath (dyspnea)
• Chest pain or discomfort (angina)
• Fatigue
• Swollen legs, ankles, or feet (edema)
• Palpitations or irregular heartbeat
• Coughing up blood (hemoptysis)

Types of Rheumatic Heart Disease

RHD can affect any of the four heart valves, but it most commonly affects the mitral valve. The types of RHD include:

• Mitral stenosis: narrowing of the mitral valve opening
• Mitral regurgitation: leakage of the mitral valve
• Aortic stenosis: narrowing of the aortic valve opening
• Aortic regurgitation: leakage of the aortic valve
• Tricuspid stenosis: narrowing of the tricuspid valve opening
• Tricuspid regurgitation: leakage of the tricuspid valve

Treatments for Rheumatic Heart Disease

The treatment of RHD depends on the severity of the condition and the extent of valve damage. Treatment options include:

• Medications:
  • Antibiotics to prevent recurrent streptococcal infections
  • Anti-inflammatory medications to reduce inflammation
  • Diuretics to reduce fluid buildup
  • Beta blockers to slow the heart rate and reduce blood pressure
• Surgery:
  • Valve repair or replacement surgery to correct damaged valves
  • Heart transplantation in severe cases
• Lifestyle modifications:
  • Avoiding strenuous activities and exercise
  • Maintaining a healthy weight
  • Quitting smoking
  • Managing stress

Prevention of Rheumatic Heart Disease

Preventing rheumatic fever is key to preventing RHD. This can be achieved by:

• Treating streptococcal infections promptly with antibiotics
• Practicing good hygiene, such as washing hands regularly
• Avoiding close contact with people who have streptococcal infections

Complications of Rheumatic Heart Disease

If left untreated or undertreated, RHD can lead to serious complications, including:

• Heart failure
• Atrial fibrillation
• Endocarditis (infection of the heart valves)
• Stroke
• Pulmonary embolism