Understanding Rheumatic Heart Disease

Rheumatic heart disease (RHD) is a serious, chronic condition that can have lasting effects on the heart. It primarily results as a complication of acute rheumatic fever, which can develop after an infection with Streptococcus bacteria. Understanding RHD's risks, symptoms, and available treatments is vital for those affected and their loved ones. This article will delve into the crucial aspects of rheumatic heart disease to help raise awareness and guide effective management.  

What Is Rheumatic Heart Disease?  

Rheumatic heart disease is a chronic heart condition resulting from rheumatic fever, which itself is a complication of untreated or inadequately treated strep throat or scarlet fever, infections caused by beta-hemolytic Streptococcus bacteria. The disease can damage the heart valves, leading to heart valve stenosis or regurgitation most commonly affecting the mitral (bicuspid) valve, and may also affect the heart muscle and pericardium. 

Risk Factors for Rheumatic Heart Disease       

The primary risk factor for developing rheumatic heart disease is from single or repeated bouts of acute rheumatic fever. Factors that increase the risk of rheumatic fever include: 

• Genetic Predisposition: A family history of rheumatic fever or RHD 
• Economic and Environmental Conditions: Overcrowding, poor sanitation, and limited access to healthcare 
• Age: It most commonly affects children between the ages of 5 and 15 years, though it can occasionally affect adults 
• Untreated Strep Infections: Not completing a full course of antibiotics for strep throat or scarlet fever 

Symptoms of Rheumatic Heart Disease  

The symptoms of RHD may vary depending on the severity and the parts of the heart affected. Common symptoms include: 

• Heart Murmurs: Unusual sounds heard during a heartbeat, indicating abnormal blood flow 
• Chest Pain or Discomfort 
• Shortness of Breath: Especially with exertion or when lying down 
• Fatigue 
• Swelling: Particularly in the ankles, wrists, or stomach 
• Palpitations: Awareness of irregular or rapid heartbeats 

Diagnosing Rheumatic Heart Disease        

Diagnosis typically involves a combination of medical history, physical examination, and diagnostic tests, such as: 

• Echocardiogram: An ultrasound of the heart to assess valve function and structure 
• Electrocardiogram (EKG/ECG): To measure the electrical activity of the heart 
• Blood Tests: To check for markers of inflammation and infection 

Treatments for Rheumatic Heart Disease    

Treatments for RHD focuses on managing the symptoms, preventing further damage to the heart, and treating any underlying strep infection. Treatment options include: 

• Antibiotics: To treat any lingering or recurrent strep infections and prevent rheumatic fever recurrence 

• Anti-inflammatory Medication: Such as aspirin or corticosteroids to reduce inflammation 
• Anticoagulants: Blood thinners to prevent blood clots in those with damaged heart valves 
• Regular Monitoring: Frequent check-ups with a cardiologist to monitor heart function
• Surgery: Valve repair or replacement may be necessary for severe valve damage 

When to Worry About Rheumatic Heart Disease         

It is important to seek medical attention if you or someone you know has symptoms of rheumatic heart disease or a history of rheumatic fever. Early detection and treatment of RHD are critical for preventing serious complications, including heart failure, stroke, and death. 

Prevention of Rheumatic Heart Disease    

The best way to prevent RHD is to prevent rheumatic fever by: 

• Promptly Treating Strep Throat: With a full course of antibiotics 
• Regular Medical Follow-ups: Especially after a diagnosis of rheumatic fever to prevent recurrence 
• Improved Public Health Measures: Such as better housing, sanitation, and access to medical care 

Rheumatic heart disease remains a significant health concern, particularly in developing countries where access to healthcare is limited. Understanding the risk factors, recognising the symptoms, and seeking timely medical treatment can help manage the disease and improve outcomes. Prevention efforts that include treating strep infections and improving living conditions are essential to reducing the incidence of RHD. By being informed and proactive, individuals can lead healthier lives and minimise the impact of this potentially life-threatening condition.