Rheumatic heart disease is caused due to rheumatic fever. Group A Streptococcal infection causes throat infection leading to rheumatic fever. Rheumatic fever affects the cartilage in the body which damages heart valves,...
Rheumatic heart disease or rheumatic heart is caused due to rheumatic fever. Repeated and untreated group A streptococcal infections (GAS) can lead to acute rheumatic fever. GAS infection activates autoimmune responses causing inflammation and scarring of the heart valves. The inflammatory disease affects the connective tissue of the heart, joints, skin, or brain. Rheumatic heart valve damage due to strep throat can cause RHD disease.
Streptococcal pyogens bacteria infection most commonly affects children. The infection is contagious and can spread from one person to another in a similar way as upper respiratory tract infection spreads
What Causes of Rheumatic Heart Condition?
RHD cardiac disease is caused due to long-standing and untreated streptococcal infection. The streptococcal infection triggers an autoinflammatory response. The inflammatory responses start to damage connective tissues of various body parts such as the heart, the brain, skin, and joints. When inflammatory responses start degrading heart muscles and valves, the rheumatic heart valves start to scar over time. The scarring of heart valves narrows them down and makes them leaky. Affected heart valves affect the functioning of the heart. Years after rheumatic fever and with the progressive loss in heart functionality, the chances of getting heart failure are high.
Who Gets Affected With RHD Heart Disease?
Streptococcal pyogen infection most commonly affects children and teenagers. When the untreated, chronic, or maltreated strep infection persists, rheumatic heart problems start to develop. Rheumatic heart diseases start with rheumatic fever. Rheumatic heart disease symptoms are seen years after the rheumatic fever/rheumatic infection has subsided.
Rheumatic Fever And Pregnancy
Women and girls have higher chances of developing rheumatic heart diseases than men. During pregnancy, your body needs to pump extra blood to meet the demand of a growing fetus and your body, due to rheumatic fever valve disease affects the functioning of the heart valve which decreases the pumping efficiency of the rheumatic heart, thereby affecting the health status of the growing fetus and the mother.
Rheumatic Heart Disease Pregnancy Complications
Decreased pumping efficiency of the heart of a pregnant lady can cause rheumatic fever complications later in life, and during the pregnancy such as
- Death of the mother
- Death of the baby
- Preterm delivery
- Chances of heart failure shortly before, during or after delivery
- Chances of other pregnancy complications
Signs and Symptoms of Rheumatic Heart Disease
Signs and symptoms of rheumatic fever start 1-6 weeks after the strep throat infection
The most common symptoms of rheumatic fever are
- Fever
- Arthritis- Very painful joints (knees, ankles, elbows, and wrists)
- Moving pain between joints
- Rheumatic heart disease skin rash that is red, raised, lattice-like.
- Rashes on the chest, back, and belly.
- Weakness and fatigue
- Subcutaneous nodules- Painless nodules under the skin near joints
- Rarely, a rash having pink rings with a clear center can occur
- Chorea- Uncontrollable jerky body movements (arms, legs, or facial muscles)
- Carditis- inflammation of heart muscle and heart tissue causing, rapid heart rae, fatigue, exercise intolerance and shortness of breath.
Symptoms of Rheumatic Heart Disease
- Chest discomfort and chest pain
- Fatigue
- Heart murmur
- Swelling
- With increased activity and on lying, you mighty feel shortness of breath
- Arrhythmias
What are the Diagnostic Tests for Rheumatic Heart Disease
Diagnostic Evaluation of Rheumatic Fever
Diagnosis of recent streptococcal infection
- Throat culture
- Blood test-
- C-reactive protein (CRP)
- Erythrocyte sedimentation rate (ESR)
RHD Diagnosis
- Echocardiogram test (ECHO)
- Electrocardiogram (ECG)
- Chest X-ray
- Cardiac MRI
What Are the Complications of Rheumatic Heart Disease?
Complications of RHD
- Heart failure- Due to narrowed and leaking heart valves
- Complications during pregnancy such as decreased pumping efficiency of the heart
- Complications during delivery- Fetal or maternal death might happen during or shortly before the delivery.
- Bacterial endocarditis- An infection of the inner lining of the heart.
- Ruptured heart valves can be treated with heart valve replacement surgery or by fixing the valve surgically.
How to Treat Rheumatic Heart Diseases
Symptoms of Rh Fever Can Be Treated With
- Medications- medicines such as anticoagulants are used to reduce the risk of stroke or blood clots. Arrhythmias are also managed with appropriate medication.
- Surgery- progressed rheumatic heart diseases often require surgeries such as heart valve replacement surgery where the surgeon replaces the rheumatic heart valve with a prosthetic heart valve. A damaged valve can be repaired with surgery if the disease has not progressed so much.
Treatment of Rheumatic Fever
Rheumatic fever is often managed with appropriate medications such as antibiotic penicillin, aspirin, and other medicines. Children are often kept on low-dose penicillin for several years to minimize the risk of recurrence of rheumatic fever and complications. Recurrence of the disease often leads to rheumatic heart disease, therefore its prevention plays a crucial role.
Results
A properly managed and treated rheumatic fever doesn't progress into rheumatic cardiac disease. If the disease is not managed well, the quality of life is affected and deteriorates. To prevent long-term care, timely diagnosis and appropriate treatment need to be taken.
