Last updated on January 11, 2022
Content By: Dr. Nikita Toshi BDS, Assistant Manager (Medical Review), Dr. Ritu Budania MBBS, MD (Pharmacology) Head, Medical Affairs
Last updated on January 11, 2022
Rheumatic heart disease is a condition affecting your heart and blood vessels that can be caused by a bacterial infection. This leads to an inflammation of the lining of one or more chambers of the heart and damage to valves.
The rheumatic heart disease diagnosis usually starts with heart check-ups, taking blood tests for rheumatic factors, blood cultures for bacteria in order to identify if there is any bacterial infection present. The bacterium, Streptococcus, may also affect other structures especially the valves of the heart. Rheumatic heart disease is a long-term ailment that can cause pain in the chest, shortness of breath, tiredness and even death if left untreated.
Thus, it is important that we know more about rheumatic heart disease and rheumatic heart disease treatment before we can take a step towards reducing the risk of disease and associated complications.
This article will provide you with information on rheumatic heart disease and various rheumatic heart disease treatment options available in India, that can help manage the condition effectively.
Rheumatic heart disease is a condition affecting your heart and blood vessels that can be caused by a bacterial infection. This leads to an inflammation of the lining of one or more chambers of the heart and damage to valves.
The rheumatic heart disease diagnosis usually starts with heart check-ups, taking blood tests for rheumatic factors, blood cultures for bacteria in order to identify if there is any bacterial infection present. The bacterium, Streptococcus, may also affect other structures especially the valves of the heart. Rheumatic heart disease is a long-term ailment that can cause pain in the chest, shortness of breath, tiredness and even death if left untreated.
Thus, it is important that we know more about rheumatic heart disease and rheumatic heart disease treatment before we can take a step towards reducing the risk of disease and associated complications.
This article will provide you with information on rheumatic heart disease and various rheumatic heart disease treatment options available in India, that can help manage the condition effectively.
Written by
BDS, Assistant Manager (Medical Review)
Reviewed by
MBBS, MD (Pharmacology) Head, Medical Affairs
Rheumatic heart disease (RHD) is a heart condition that results from damage to heart valves and tissues caused by the inflammation and scarring caused by rheumatic fever. The condition starts as a sore throat from a bacterium called Streptococcus pyogenes (group A streptococcus). The sore throat caused by this bacterium is referred to as strep infection. Repeated occurrences of strep infections can lead to rheumatic fever, which occurs when the immune system reacts against the tissues of the body. These autoimmune reactions also include inflammation and scarring of the heart valves, which ultimately leads to damage in the valves and affects the functioning. While RHD usually affects children between the ages of five and fifteen, older children and adults can also be at risk for the disease.
Rheumatic fever is a long-term ailment. In India, an estimated 2 – 3 million people have RHD. This means the overall prevalence is estimated to be about 1.5-2/1000 in all age groups.
The most common rheumatic heart disease symptoms include pain in the chest, shortness of breath and tiredness. In rare cases, death is also possible if the condition is not properly diagnosed and treated.
Rheumatic heart disease can be easily prevented with antibiotic treatment of acute rheumatic fever within ten days of infection with strep throat. However, antibiotics are only effective in about 50% – 75% of cases when taken after four weeks following an infection. Thus, it is important to identify and prevent rheumatic fever early on before it causes any major damage.
In addition to these problems, there are certain complications that result from rheumatic fever, such as mitral valve regurgitation, a condition in which the mitral valve doesn’t close properly, allowing blood to flow backwards in your heart. This, in turn, can lead to other heart conditions. Various RHD treatment options can help prevent such complications.
Rheumatic heart disease is the most common heart disease in people under age 25.
This heart disease is responsible for around 300 deaths around the world, each year, majorly in low or middle-income countries.
It can be prevented to a significant extent by preventing strep infections or treating them with antibiotics immediately when they occur.
Rheumatic heart disease is more common in children but it can affect anyone. Children having risk factors of rheumatic heart disease are those who have had rheumatic fever before the age of five and they may also be affected by socioeconomic factors such as poor living conditions, lack of education on how to prevent infections, etc. With that said, RHD is still common in places, such as south-central Asia, sub-Saharan Africa and among certain populations in New Zealand and Australia.
One of the best ways to detect chronic rheumatic heart disease is through a proper rheumatic heart disease diagnosis, which involves physical examination, tests for heart and some blood tests. Doctors listen for abnormal sounds due to the narrowing of arteries coupled with an echocardiogram (an ultrasound image) that shows the thickening of your valves on one or both sides of your heart.
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Rheumatic heart disease affects the valves of your heart. Valves are the part of the organ that open and close when necessary for blood flow between different chambers or parts of the heart. When you have rheumatic fever heart, it causes inflammation in these tissues, leaving them stiffened and narrowing their opening, restricting blood flow. In addition, rheumatic heart disease causes other complications like mitral stenosis (a condition where the valve is narrowed), which can lead to other conditions such as congestive heart failure, pulmonary edema (fluid accumulation in the lungs).
Rheumatic fever and its effect on the heart valve. The exact cause of the diagnosis of rheumatic fever is not known. However, it occurs when the bacterium called Group A Streptococcus causes strep throat. This leads to an autoimmune response where the immune system attempts to destroy these bacterial cells but ends up attacking the healthy tissues too.
If you have suffered from strep throat before the age of five, it leaves your body vulnerable to this disease later on. However, having had strep throat does not always mean that you will develop RHD. Only about 15% – 20% of people who are susceptible end up developing it.
The bacterium has to be taken into consideration, too. It might spread like other respiratory infections from person to person or enter your body enter through a small cut or wound and spread throughout your blood vessels until they reach your joints and muscles, causing the inflammation that chronic rheumatic heart disease fever is known for. If left untreated, people can get complications such as scarring in the lining and valves in your heart, leading to RHD.
As far as symptoms are concerned, they depend on which valve you have been affected by RHD. Sometimes there may be no RHD symptoms or signs at all. However, if left untreated for long periods, it can lead to other conditions, such as pulmonary edema (fluid accumulation in the lungs), that makes breathing difficult. It could also cause congestive heart failure where your heart cannot pump enough blood throughout your body, causing swelling in different parts, including feet and legs due to fluid buildup.
The following are the known symptoms of complications of rheumatic heart disease that one must keep in mind. These include:
Fever – You may feel a sudden onset of rheumatic fever that lasts for more than three days. This is because of the autoimmune response that occurs in your body when it starts to attack its own healthy tissues due to strep throat. The fever can get severe with the patient’s body temperature reaching above (100°C) if not treated on time.
Swollen, tender, red and very painful joints – Since the disease affects your joints, including those in your legs, ankles, feet and wrists as well as knees, you will feel a sudden onset of swelling along with the pain and stiffness that may last for two to three weeks before subsiding completely. The joints can get swollen into large proportions, it may also cause deformity in the joints if not treated on time.
Lumps under the skin – These are caused due to rheumatic fever, which causes your body’s immune system to attack its own healthy tissues. Therefore, you will feel these lumps underneath your skin all over your body, including your legs and thighs. If they become large in size or number, it could lead to other issues. They can be painful too.
Red, raised, lattice-like rash – The autoimmune response also affects your blood vessels, causing them to dilate and become wider than usual. This makes the individual’s body warm, which is why they may complain about feeling extremely hot! You can even notice a change in their complexion as well, with it becoming very bright or reddish-looking due to increased blood supply throughout the area that has been affected by rheumatic fever. Breathing problems such as wheezing are usually noticed too.
Uncontrolled movements of arms, legs or facial muscles – This is referred to as chorea and can affect people of all age groups. However, it generally appears in children who cannot control their body movements anymore. Since the muscles are not working properly due to damage caused by complications of rheumatic heart disease, you will find them twitching uncontrollably without any apparent reason whatsoever!
Symptoms of heart valve damage that is associated with rheumatic heart disease may include:
Chest pain or discomfort
Swelling of the stomach, hands or feet
Weakness and fatigue
Irregular heartbeat
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An early diagnosis of rheumatic heart disease can help in effective treatment and also help prevent various complications resulting from the condition. RHD can be tested and diagnosed using a number of ways such as:
Based on the medical history – The doctor will look through your medical history, before recommending any tests, as any evidence of rheumatic or strep infection in your medical records indicate that you have increased chances of having rheumatic heart disease.
Echocardiogram – This is a test for rheumatic fever that uses ultrasound to create images of the heart. In case there are any rheumatic heart disease signs and symptoms present, they will be detected by this test and identified as RHD treatment! An echocardiogram helps in understanding the size and shape of your heart, as well as any defects or problems that may be present in it.
Electrocardiogram – This is another test in which your heart’s electrical activity and its rhythm can be analyzed. In this case, a rheumatic fever heart will show up at long or irregular QT intervals. An electrocardiogram allows the doctors to see your heart’s condition and the way it is working!
Chest X-rays – These help the doctor get a clear view of the structures present inside your chest so they can look out for any abnormalities such as inflammation of these areas too. Chest x-rays ensure that the doctors have a clear understanding of your heart’s condition!
Cardiac MRI – This is a type of MRI that can detect any defects or problems in the heart. It provides detailed images and allows doctors to analyze your heart’s condition more accurately. MRI uses magnetic fields and radio waves to produce images of the body’s organs.
Blood Tests – A blood test can also be helpful in diagnosing rheumatic heart disease by checking for the presence of antibodies that are produced during an RHD infection. The test for rheumatic fever allows your doctor to see your immune system’s response towards the germs that might have caused rheumatic fever in you!
Early diagnosis paves way for a better treatment plan.
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Since rheumatic fever leads to rheumatic heart disease, an effective way to avoid RHD
is by preventing the occurrence of rheumatic fever. Treatment of strep throat with the right antibiotics will help prevent rheumatic fever.
When a patient is infected with rheumatic fever, it is crucial to avoid occurrences of streptococcal infections in the future as this could lead to an additional episode of rheumatic fever and further damage to the heart valves. Treating the patient with antibiotics for a prolonged duration is one of the best ways to prevent additional streptococcal infection.
If you experience any RHD symptoms, consult your doctor immediately. If not treated well, rheumatic fever can lead to chronic conditions such as rheumatic heart disease, which does necessitate rheumatic heart disease treatment.
Your doctor might prescribe a number of different types of medications depending on how severe your condition is and other aspects too. Prevention of rheumatic heart disease includes:
Anti-inflammatory medicines to reduce the risk of heart damage – This type of medication helps reduce inflammation by decreasing swelling around inflamed tissues. They are usually given as an injection after being administered orally initially.
Antibiotics for a rheumatic fever – When you have rheumatic fever, your doctor might prescribe a course of antibiotics to help control the infection and prevent it from becoming worse. However, this type of RHD treatment can be extremely harmful if not used properly. This is because overuse or incorrect use of antibiotic medicines may lead to an increase in antibiotic-resistant bacteria known as superbugs.
Nonsteroidal anti-inflammatory drugs (NSAIDs) – These are actually anti-inflammatory medications that can be taken orally instead of being injected. Since they do not require any injections, these drugs tend to have fewer side effects! However, NSAIDs may cause stomach ulcers and increase the risk factors of rheumatic heart disease in some cases, so it is important for your doctor to monitor you closely if you take this kind of medication regularly.
If you have failed to discover that you have rheumatic heart disease early on, your doctor might recommend RHD treatment to repair or replace any badly damaged valves that are present in the chambers of your heart. Surgery is often recommended for patients who do not respond well enough to medicines and other types of rheumatic heart disease therapies.
The right medicines can help in controlling the condition to a significant degree.
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If the rheumatic heart disease treatment is not done at the right time, it can cause serious complications such as:
Heart failure – When the valves of your heart become too damaged and cannot provide adequate support to your blood pressure or circulation anymore, you might experience RHD symptoms like fatigue and shortness of breath. This condition is known as congestive cardiac failure.
Complications of pregnancy and delivery due to heart damage – Rheumatic heart disease can cause significant complications during pregnancy and while delivering a baby. Women suffering from rheumatic heart disease can become pregnant but they also have an increased risk of miscarriage, preterm labour, and delivery complications, as well as other problems.
Ruptured heart valve – In some cases, a rheumatic heart can even cause the lining of your valve to rupture and form an obstruction in the flow of blood from one chamber to another. Symptoms include chest pain as well as shortness of breath.
Taking proper medication can help avoid complications of rheumatic heart disease.
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Since there is no cure for rheumatic fever yet, it is important to learn how to prevent yourself from contracting this condition as much as possible. Although many people believe that vaccination can protect them against catching RHD treatment, it should be noted that vaccines only offer limited protection against the germs causing this condition.
However, they will help reduce the severity if contracted by an individual later on since vaccinations work best when administered at a younger age before symptoms start appearing. The following are some measures you can take in order to prevent any further complications after getting rheumatic heart disease:
Activity Restrictions – If you notice that you are experiencing fatigue, shortness of breath, chest pain or other RHD symptoms related to heart problems such as palpitations or irregular heartbeat at any time during recovery – even if these issues seemed resolved initially after RHD treatment, you should put some restrictions on your daily activities, especially the physical ones. Certain activities like intense workouts may worsen your RHD and cause further damage since your heart will have a hard time pumping blood through the body properly when it is damaged already.
Medical follow-ups – It is important for you to get regular checkups with your doctor, even after recovery, since the symptoms of this disease may reappear later in life. If left untreated over time, rheumatic heart disease can cause permanent damage to one’s health, which means it will be difficult for them to lead an active lifestyle or perform simple tasks without any risk involved.
Monthly/daily treatments – Depending on the severity of your rheumatic heart disease, you may have to take daily medications or monthly RHD treatment in order to manage this condition and prevent it from worsening. In addition to these medical follow-ups, make sure that you maintain a balanced diet with plenty of fruits and vegetables as well as exercise regularly without pushing yourself too hard at any time. This will help keep your immune system strong while also promoting better blood circulation throughout the body – which is necessary for maintaining good health overall.
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It depends on the severity of your symptoms as well as how you deal with them during rheumatic heart disease treatment. Although there is no cure for RHD, making a full recovery from this condition should be possible if one receives proper medical care and avoids any strenuous activities that may worsen their RHD over time.
No, RHD is not life-threatening. However, life-threatening complications may arise without any RHD treatment over time so make sure you get regular check-ups with your doctor to manage the condition properly.
In some cases, yes, rheumatic heart disease does need to be treated with surgery. The doctor prescribed surgery to repair one’s heart valves if the condition has caused any of them to become too narrow or stiff.
Yes, rheumatic fever can cause permanent damage to one’s heart. If left untreated over time, it may become difficult for them to lead an active lifestyle or perform simple tasks without any risk involved.
If there won’t be any RHD treatment, then it can cause permanent damage to one’s heart and overall health. As a result of this condition, it will be difficult for them to lead an active lifestyle or perform simple tasks without any risk involved!
Yes, rheumatic heart disease can be prevented by preventing the initial throat infection that triggers it. Make sure you wash your hands often and avoid sharing personal items such as towels or utensils with others to prevent contracting this condition in the first place. In case you experience symptoms of sore throat, consult a doctor and follow the complete treatment that has been prescribed to you.
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