Rheumatic Heart Disease

Content of This Page

1- Introduction

2- Causes

3- Symptoms

4- Stages of The Disease

5- Treatment

6- What Should You Avoid

Introduction

Rheumatic Heart Disease (RHD) is a condition where the heart valves are damaged as a result of rheumatic fever, a complication of untreated strep throat or scarlet fever. Rheumatic fever is an inflammatory disease that can develop after an infection with Group A Streptococcus bacteria. The inflammation can affect the heart, leading to scarring and deformity of the heart valves.
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Causes

  • Rheumatic Fever: A complication of untreated or inadequately treated strep throat or scarlet fever caused by Group A Streptococcus bacteria.

  • Strep Throat: An infection with Group A Streptococcus that triggers an immune response which can lead to rheumatic fever if not treated properly.

  • Scarlet Fever: Another condition caused by Group A Streptococcus, which can lead to rheumatic fever and subsequently RHD if not managed effectively.

  • Genetic Factors: Some individuals may have a genetic predisposition that makes them more susceptible to developing rheumatic fever and RHD after a streptococcal infection.

  • Immune Response: The body’s immune response to the streptococcal infection can mistakenly attack the heart valves, leading to inflammation and damage.

Symptoms

  • Shortness of Breath: Difficulty breathing, especially during physical activity or when lying flat.
  • Chest Pain: Pain or discomfort in the chest, which may be related to heart valve issues.
  • Fatigue: Persistent tiredness and reduced exercise tolerance.
  • Swelling: Swelling in the legs, ankles, or abdomen due to fluid buildup.
  • Palpitations: Irregular or rapid heartbeats.
  • Fever: Often a sign of ongoing inflammation or infection.
  • Heart Murmur: An abnormal sound heard through a stethoscope, indicating valve dysfunction.
  • Joint Pain: Although more common in rheumatic fever, joint pain may persist and indicate ongoing inflammation.
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Stages of The Disesae

1. Initial Rheumatic Fever

  • Description: The acute phase following untreated strep throat or scarlet fever. Symptoms include fever, joint pain, rash, and heart inflammation (pancarditis).
  • Impact: Early damage to heart valves may begin during this phase, but symptoms are typically more generalized and related to systemic inflammation.

2. Acute Rheumatic Heart Disease

  • Description: During or shortly after rheumatic fever, inflammation of the heart valves occurs. This can cause valve damage and affect heart function.
  • Symptoms: Shortness of breath, chest pain, and fatigue. Heart murmurs may be detected due to valve dysfunction.

3. Chronic Rheumatic Heart Disease

  • Description: Long-term damage resulting from repeated episodes of rheumatic fever or ongoing valve inflammation. This stage involves scarring and deformity of the heart valves.
  • Symptoms: Persistent symptoms such as chronic shortness of breath, swelling, and fatigue. Complications like heart failure and atrial fibrillation may develop.

4. Advanced Rheumatic Heart Disease

  • Description: Severe valve damage leads to significant impairment of heart function. This stage may require surgical intervention.
  • Symptoms: Severe heart failure symptoms, significant swelling, and potentially life-threatening complications like stroke or severe arrhythmias.

Treatment

1. Antibiotic Therapy

  • Purpose: To prevent recurrent rheumatic fever, which can cause further valve damage.
  • Commonly Used: Long-term antibiotics, such as penicillin, to prevent streptococcal infections.

2. Anti-inflammatory Medications

  • Purpose: To reduce inflammation in the heart and manage symptoms.
  • Types: Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

3. Medications for Heart Failure

  • Purpose: To manage symptoms of heart failure and improve heart function.
  • Types: Diuretics, ACE inhibitors, beta-blockers, and other heart failure medications.

4. Valve Replacement or Repair Surgery

  • Purpose: To address severe valve damage that affects heart function.
  • Types: Surgical repair or replacement of damaged valves, often with mechanical or biological valves.

5. Management of Complications

  • Purpose: To address any complications arising from RHD, such as arrhythmias or stroke.
  • Types: Medications or procedures to manage irregular heartbeats and prevent clot formation.

6. Lifestyle Modifications

  • Purpose: To support overall heart health and manage risk factors.
  • Recommendations: Heart-healthy diet, regular exercise, smoking cessation, and weight management.

7. Regular Monitoring

  • Purpose: To track the progression of the disease and adjust treatment as needed.
  • Includes: Regular check-ups with a cardiologist, echocardiograms, and other diagnostic tests.

What Should You Avoid

  • Skipping Medications: Missing doses of prescribed antibiotics or heart medications can worsen the condition.
  • Untreated Infections: Ignoring or delaying treatment for infections, particularly strep throat, which can trigger rheumatic fever.
  • Excessive Physical Exertion: Engaging in strenuous activities that can stress the heart and exacerbate symptoms.
  • Smoking: Smoking can worsen cardiovascular health and increase the risk of complications.
  • Excessive Alcohol Consumption: Can negatively impact heart function and interact with medications.
  • Unhealthy Diet: Diets high in sodium, saturated fats, and cholesterol can contribute to worsening heart disease.
  • High-Stress Situations: Chronic stress can adversely affect heart health and increase the risk of complications.
  • Ignoring Regular Check-Ups: Failing to attend follow-up appointments and monitoring can lead to missed opportunities for early intervention and management.
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