What is Rheumatic Heart Disease?
Rheumatic Heart Disease (RHD) is a condition caused by permanent damage to the heart valves following an episode of rheumatic fever. Rheumatic fever is an inflammatory disease that occurs as a complication of untreated or inadequately treated strep throat or scarlet fever, caused by Group A Streptococcus bacteria.
Over time, RHD can lead to valve stenosis (narrowing), valve regurgitation (leaking), and eventually heart failure if left untreated.
Causes and Risk Factors
The primary cause of RHD is repeated or severe cases of rheumatic fever. Other risk factors include:
- Untreated Strep Throat: Delayed or incomplete treatment increases risk.
- Recurrent Rheumatic Fever: Multiple episodes worsen heart valve damage.
- Poor Access to Healthcare: Lack of antibiotics for strep throat increases prevalence.
- Overcrowded Living Conditions: Increases exposure to strep bacteria.
- Genetic Susceptibility: Family history may play a role in vulnerability.
Symptoms of Rheumatic Heart Disease
Symptoms depend on the severity of valve damage and may develop years after an episode of rheumatic fever. Common symptoms include:
- Shortness of Breath: Especially during exertion or while lying down.
- Chest Pain: Due to heart valve dysfunction.
- Fatigue: Reduced blood circulation leading to weakness and tiredness.
- Swelling in Legs and Abdomen: Fluid retention due to heart failure.
- Heart Murmur: Abnormal heart sounds detected during a medical exam.
- Irregular Heartbeats (Arrhythmias): Caused by valve dysfunction.
Diagnosis of Rheumatic Heart Disease
Doctors diagnose RHD using a combination of medical history, physical examination, and diagnostic tests:
- Medical History: Previous rheumatic fever episodes or untreated strep infections.
- Physical Examination: Detection of heart murmurs and signs of valve disease.
- Echocardiogram: Ultrasound imaging of the heart to assess valve damage.
- Electrocardiogram (ECG): Identifies abnormal heart rhythms.
- Chest X-ray: Detects heart enlargement and fluid in the lungs.
- Blood Tests: Checks for signs of past streptococcal infection.
Treatment Options
Treatment focuses on managing symptoms, preventing complications, and stopping further valve damage:
- Antibiotics: Long-term penicillin therapy prevents recurrent rheumatic fever.
- Anti-Inflammatory Medications: Reduces inflammation and pain.
- Diuretics: Helps reduce fluid buildup in the lungs and body.
- Beta-Blockers: Controls irregular heart rhythms.
- Heart Valve Repair: Restores valve function without replacement.
- Heart Valve Replacement: Required in severe cases of valve damage.
Prevention and Lifestyle Changes
Preventing rheumatic heart disease involves early treatment of strep throat and managing risk factors:
- Timely Antibiotic Treatment: Complete all prescribed antibiotics for strep infections.
- Regular Medical Check-Ups: Monitor heart function if diagnosed with rheumatic fever.
- Healthy Diet: Maintain a balanced diet to support heart health.
- Exercise and Weight Management: Helps reduce strain on the heart.
- Avoid Smoking and Alcohol: Reduces additional heart stress.