Rheumatic heart disease is a condition in which rheumatic fever causes irreversible damage to the heart valves. Heart valve damage may begin soon after an untreated or untreated streptococcal infection, such as a sore throat or scarlet fever. The immune response triggers an inflammatory condition in the body that can cause permanent valve damage.
Causes
Rheumatic fever causes Rheumatic heart disease. Rheumatic fever is a type of inflammatory disease that can affect many connective tissues, especially the joints, heart, brain or skin. The valves of the heart become inflamed and can be damaged over time. This can cause the heart valves to narrow or leak, making it difficult for the heart to function properly. This can take years and can lead to heart failure. This fever occurs at any age, but mostly occurs in children aged 5 to 15 years.
Untreated streptococcal infections may increase the risk of rheumatic heart disease. Children with repeated streptococcal infections are at greatest risk this disease as well as rheumatic fever.
Symptoms
Rheumatic fever symptoms vary and usually begin 1 to 6 weeks after a sore throat. In some cases, the infection may be too mild to be detected, or the infection may have disappeared by someone who has seen a doctor. The most common symptoms are;
- Tender, Swollen and red as well as extremely painful joints particularly in the ankles and knees
- Fever
- Nodules (lumps under the skin)
- Chest Discomfort and Shortness of breath
- Weakness
- Raised, red coloured rash usually on the back, chest and abdomen
- Uncontrolled movements of legs, arms or facial muscles
Rheumatic heart disease symptoms are Chest pain, Shortness of breath especially when lying down or during any activity and swelling.
Diagnosis
People with rheumatic heart disease have or have recently been infected with streptococcal infection. One can check for streptococci using a pharyngeal culture or a blood test. One may hear noise and fricatives during regular health check-up. Heart murmurs are caused by blood leaking around a damaged valve. Friction occurs when inflamed heart tissue moves or rubs against each other.
Other methods are:
Echocardiogram test which uses sound waves to check the chambers and valves of the heart. Echo sound waves create an image on the screen as an ultrasound transducer passes through the skin over the heart. Echoes can indicate backflow of blood through the leaking valve, damage to the valve tip, enlarged heart and fluid around the heart.
Electrocardiogram test records the intensity and timing of electrical activity in the heart. It may show an abnormal rhythm (arrhythmia or arrhythmia) and detect myocardial damage. A small sensor is taped to the skin to detect electrical activity.
Chest X-Ray, Cardiac MRI’s and Blood tests are also done to diagnose this disease.
Treatment
Prevention of rheumatic fever is the best treatment. Antibiotics can usually treat streptococcal infections and prevent the development of rheumatic fever. Anti-inflammatory drugs can be used to reduce inflammation and reduce the risk of heart damage. Other medications may be needed to treat heart failure. People with rheumatic fever receive frequent or monthly antibiotic treatment, perhaps for life, so as recurrent infections doesn’t happen and reduce the risk of further heart damage. Aspirin, steroids, or non-steroidal drugs can be given to reduce inflammation. Treatment is also highly dependent on the extent of damage of the heart valves and in some cases surgery is also required.
