Rheumatic heart disease is the injury of heart valves due to rheumatic fever. Rheumatic fever is an autoimmune response to untreated streptococcal infection that may affect the heart, joints, brain, and subcutaneous tissue. The causing organism of rheumatic fever may be group A streptococcus (GAS) or streptococcus pyrogens.
The most common age of rheumatic fever is from 5-15 years old, but it may rarely occur at any age. Rheumatic heart disease causes the death of 300000 people every year. We can see this disease more in developing countries due to the lack of antibiotics and proper health care. Your child is at risk of this disease in an unhealthy environment or with repeated streptococcal throat infections.
Rheumatic fever occurs due to the similarity between the streptococcus antigen and the antigens of the heart, joints, and other connective tissues. So, the antibodies that your body produces against streptococcus attack the heart and other tissues.
Rheumatic fever causes exudative or proliferative lesions. Exudative lesions affect the serous membranes like the pericardium and pleura and heal without fibrosis. Proliferative lesions affect the heart and skin and heal by fibrosis. Mitral valve fibrosis occurs in 90% of cases, but fibrosis can also involve the aortic valve. The fibrosis may lead to stenosis or regurge these valves.
The symptoms of rheumatic fever take from 2-3 weeks to develop. Your child may feel fever, fatigue, painful joints, painless nodule, and (or) chorea. Rheumatic fever damages the heart valves. So, your child may complain of chest pain, shortness of breath, fatigue, and irregular heartbeat. In severe cases, your child may develop heart failure, arrhythmia, and atrial fibrillation, which may be fatal.
The doctor can diagnose your child depending on some factors. He will ask about the symptoms that make him suspect the disease. At first, your doctor diagnoses rheumatic fever through two criteria: major and minor criteria. Major criteria are carditis, arthritis, subcutaneous nodule, chorea, and erythema marginatum. Minor criteria include fever, elevated ESR, arthralgia, and elevated C-reactive protein. Then, your doctor will ask about some tests to check heart health. These tests like echocardiogram, and electrocardiogram (ECG).
There is no medical treatment for rheumatic heart disease because the injury of heart valves becomes permanent. So, the only cure is surgical intervention according to the severity of the damage. Your doctor will repair the heart valve if he can. But, he may need to replace them if the damage is very severe. Your doctor may use medications only to relieve the symptoms and decrease the risk of blood clots formation.
You can avoid rheumatic heart disease only through the prevention of rheumatic fever. You or your child should take proper antibiotics when you feel any symptoms of streptococcal infection. Finally, you should know that rheumatic heart disease is dangerous in pregnant women due to a lack of blood supply.
Now, let’s see this disease in more detail and answer the following questions:
- What causes this disease, and who is at risk?
- What is the pathophysiology of it?
- How many people do have rheumatic heart disease?
- What are its symptoms, signs, and complications?
- How will your doctor diagnose and confirm this disease?
- How can your doctor manage this disease, and what are the treatment options?
- Can you prevent rheumatic heart disease, and how can you do this?
- Rheumatic heart disease in pregnant women
- What is the prognosis?