Rheumatic heart disease is a condition in which the heart valves are damaged by rheumatic fever.
Rheumatic fever begins with a strep throat from streptococcal infection. Rheumatic fever is an inflammatory disease. It can affect many of the body’s connective tissues — especially those of the heart, joints, brain or skin. Anyone can get acute rheumatic fever, but it usually occurs in children five to 15 years old. The rheumatic heart disease that results can last for life.
WHAT ARE THE SYMPTOMS OF RHEUMATIC HEART DISEASE (RHD)?
Symptoms vary greatly. Often the damage to heart valves isn’t immediately noticeable. A damaged heart valve either doesn’t fully close or doesn’t fully open.
Eventually, damaged heart valves can cause serious, even disabling, problems. These problems depend on how bad the damage is and which heart valve is affected. The most advanced condition is congestive heart failure. This is a heart disease in which the heart enlarges and can’t pump out all its blood.
CAN RHD BE PREVENTED?
The best defense against rheumatic heart disease is to prevent rheumatic fever from ever occurring. By treating strep throat with penicillin or other antibiotics, doctors can usually stop acute rheumatic fever from developing.
People who’ve already had rheumatic fever are more susceptible to attacks and heart damage. That’s why they’re given continuous monthly or daily antibiotic treatment, maybe for life. If their heart has been damaged by rheumatic fever, they’re also at increased risk for developing bacterial endocarditis, an infection of the heart’s lining or valves.
WHAT ARE THE IMPORTANT ASPECTS OF RHD?
Mortality/Morbidity:
Rheumatic heart disease is the major cause of morbidity from rheumatic fever and the major cause of mitral insufficiency and stenosis in the world. Variables that correlate with severity of valve disease include the number of previous attacks of rheumatic fever, the length of time between the onset of disease and start of therapy, and sex. (The disease is more severe in females than in males.) Insufficiency from acute rheumatic valve disease resolves in 60-80% of patients who adhere to antibiotic prophylaxis.
Sex:
Rheumatic fever occurs in equal numbers in males and females, but the prognosis is worse for females than for males.
Age:
Rheumatic fever is principally a disease of childhood, with a median age of 10 years, although it also occurs in adults (20% of cases)