Rheumatic heart disease is one of the most common acquired heart diseases in people below the age of 25. It is known to affect around 55 million people worldwide. It claims around 360,000 lives every year. The death toll due to this disease is also very high in India.
In this disease, heart valves get damaged. This damage is triggered by one or several episodes of rheumatic fever, which in turn is an autoimmune inflammatory response to a throat infection. The main causative agent behind this infection is a bacterium named “group A streptococci.” This throat infection is commonly called strep throat.
It mostly affects kids and may cause death or lifelong disability if not treated timely. Rheumatic heart disease is life-threatening but preventable if strep throat is diagnosed and treated properly with antibiotics. Let’s learn more about this disease in the following article.
What are the Causes of Rheumatic Heart Disease (RHD)?
Rheumatic fever is the main cause behind rheumatic heart disease. Many connective tissues, particularly those in the heart, joints, skin, or brain, may be harmed by this inflammatory disease. Over time, the heart valves may develop chronic inflammation and scarring. This may cause the heart valve to narrow or leak. The heart finds it more difficult to function regularly as a result, ultimately resulting in heart failure. However, it may take years to manifest. Although it can happen at any age, it usually affects children between the ages of five and fifteen.The risk of rheumatic heart disease is high in people with untreated or inadequately treated strep infections. Rheumatic fever and rheumatic heart disease are more common in children who have recurrent strep throat infections.
What are the Symptoms of Rheumatic Heart Disease (RHD)?
When experiencing an acute attack of rheumatic fever, certain individuals may exhibit signs of heart disease. However, signs of rheumatic heart disease typically go undetected for years following a rheumatic fever or strep infection. The following signs may indicate an underlying heart damage:- Fever
- Swollen and painful joints (particularly the knees and ankles)
- Lumps under the skin (nodules)
- Red, raised, lattice-like rashes mostly on the chest, back, and belly
- Shortness of breath with exercise, at rest or when lying flat
- Uncontrolled movements of arms, legs, or facial muscles
- Weakness
- Chest pain
- Fatigue
- Heart murmur
- Swelling in your stomach, hands or feet
- Palpitations
- Coughing up blood
What are the Complications of Rheumatic Heart Disease (RHD)?
About 20 or 30 years after a rheumatic fever episode, the illness may have an impact on your heart. You may experience the effects of rheumatic heart disease earlier in your younger age if you had recurrent episodes or were younger when you had rheumatic fever. About 20 or 30 years after an attack of rheumatic fever, cardiac problems may arise. You could experience the effects of rheumatic heart disease at a younger age if you experienced rheumatic fever more than once or if you were younger.A condition known as stenosis of the valve occurs when one or more of your heart valves constrict or let blood flow backward in the incorrect direction. This is referred to as regurgitation by doctors. The mitral and aortic heart valves are commonly affected by rheumatic heart disease. The following are the complications of rheumatic heart disease:
- Arrhythmia (abnormal heart rhythms, such as atrial fibrillation).
- Infective endocarditis (infection of heart valves)
- Pulmonary hypertension
- Heart failure
What are the Diagnostic Tests for Rheumatic Heart Disease (RHD)?
People who have rheumatic heart disease are likely to have experienced a strep infection in the past. Strep can be detected with a blood test or throat culture. A normal physical examination may reveal a murmur or rub. The murmur is the result of blood seeping around the injured valve. The rub is brought on by the movement or rubbing of the inflammatory cardiac tissues. In addition to a thorough medical history and physical examination, rheumatic heart disease may be diagnosed by the following tests:- Blood tests
- Chest X-ray
- Echocardiogram (an ultrasound of your heart)
- Electrocardiogram (EKG, a test of your heart’s electrical activity)
What are the Treatment Options for Rheumatic Heart Disease (RHD)?
| Treatment Type | Description |
| Medications | Includes drugs for managing heart failure, correcting abnormal heart rhythms, and anticoagulants to lower the risk of stroke or blood clots in patients with mitral valve narrowing or atrial fibrillation. These help control symptoms and may slow disease progression. |
| Minimally Invasive Procedure (Valvuloplasty) | A balloon-based procedure used to widen a narrowed mitral valve when there are no major structural issues. Improves blood flow and reduces symptoms like shortness of breath. |
| Heart Valve Surgery | Required in severe rheumatic heart disease. Surgeons repair or replace damaged heart valves using mechanical or tissue valves when repair isn’t possible. Restores proper valve function. |
| Ross Procedure | A specialized surgery where a healthy valve is moved to replace the damaged one, and a new valve is inserted in the healthy valve’s original position. Offers long-term durability; often used in suitable younger patients. |
Conclusion
It's possible that your childhood strep infections were beyond your control. However, rheumatic heart disease is something you can address right now. Take control of your health by seeing a physician about the best course of action for treating your heart condition and preventing more infections. Adhering to a doctor's recommendations for maintaining your health is one of the best things you can do. When your heart needs the best care, the best cardiologists at Asian Heart Institute are here for you. For expert care, book your consultation now!FAQs
Q1. How long can a person live with RHD?A: With timely treatment and regular follow-ups, many people with RHD can live for decades with a good quality of life.
Q2. What is the main cause of rheumatic disease?
A: Rheumatic heart disease is mainly caused by untreated or poorly treated strep throat or scarlet fever, which leads to rheumatic fever and later heart valve damage.
Q3. What are the warning signs of RHD?
A: Common warning signs include breathlessness, chest pain, fatigue, palpitations, and swollen legs.
