Rheumatic Heart Disease: Symptoms, Causes, Treatment

What are the symptoms of rheumatic heart disease?

Rheumatic heart disease is a condition where the heart valves are damaged as a result of rheumatic fever. The symptoms can vary depending on the severity and which heart valves are affected. Common symptoms include:

• Shortness of Breath: Difficulty breathing, especially during physical activity or when lying flat, due to heart failure or fluid buildup in the lungs.
• Chest Pain: Discomfort or pain in the chest, which can be related to inflammation of the heart lining or valve dysfunction.
• Fatigue: Persistent tiredness or weakness, often due to the heart’s reduced ability to pump blood effectively.
• Palpitations: Noticeable or irregular heartbeats, which may occur if the heart valves are not functioning properly.
• Swelling: Fluid retention in the legs, ankles, or abdomen, caused by heart failure and poor circulation.
• Fainting or Dizziness: Lightheadedness or fainting spells can occur due to decreased blood flow or heart rhythm disturbances.
• Heart Murmurs: Abnormal heart sounds that can be detected during a physical examination, indicating valve problems such as stenosis or regurgitation.
• Arthralgia: Joint pain or swelling, which may be associated with the underlying rheumatic fever but can also be related to heart involvement.

Symptoms of rheumatic heart disease can range from mild to severe and often require evaluation by a healthcare provider to determine the appropriate treatment and management strategies.

What are the causes of rheumatic heart disease?

Rheumatic heart disease primarily results from rheumatic fever, a complication of untreated or inadequately treated streptococcal throat infections, such as strep throat or scarlet fever. Here’s a breakdown of the causes:

• Streptococcal Infection: The primary cause of rheumatic heart disease is a bacterial infection with Group A Streptococcus (GAS). If this infection is not properly treated with antibiotics, it can trigger rheumatic fever.
• Rheumatic Fever: This is an inflammatory disease that can develop as a complication of untreated or inadequately treated streptococcal infections. Rheumatic fever can affect multiple parts of the body, including the heart, joints, skin, and nervous system.
• Autoimmune Response: The body’s immune system may mistakenly attack its own tissues after the streptococcal infection. In rheumatic fever, this autoimmune response can lead to inflammation of the heart valves, resulting in long-term damage.
• Repeated Infections: Individuals who experience recurrent streptococcal infections without appropriate treatment are at higher risk of developing rheumatic fever and, subsequently, rheumatic heart disease.
• Genetic Factors: Genetic predisposition may play a role in the susceptibility to rheumatic fever and rheumatic heart disease. Some individuals may have a genetic tendency to develop a more severe autoimmune reaction to streptococcal infections.
• Socioeconomic and Environmental Factors: Poor living conditions, overcrowding, and limited access to medical care can increase the risk of streptococcal infections and, consequently, rheumatic fever and heart disease.

Effective treatment of streptococcal infections with antibiotics can prevent rheumatic fever and the development of rheumatic heart disease.

What is the treatment for rheumatic heart disease?

The treatment for rheumatic heart disease aims to manage symptoms, prevent further damage, and address any complications. To start, medications play a crucial role. Anti-inflammatory drugs, such as aspirin or ibuprofen, help reduce inflammation and pain. In more severe cases, corticosteroids like prednisone may be used. Long-term antibiotic prophylaxis is also important to prevent recurrent streptococcal infections and further episodes of rheumatic fever. This typically involves either monthly injections of benzathine penicillin or daily oral antibiotics.

When managing heart complications, medications for heart failure, such as diuretics, ACE inhibitors, and beta-blockers, may be prescribed to alleviate symptoms and reduce the heart’s workload. Anticoagulants might be used if there’s a risk of blood clots. In cases of severe valve damage, surgical options, including valve repair or replacement, may be necessary to restore proper heart function.

Lifestyle modifications are also important. Adopting a heart-healthy diet and regular exercise can help manage symptoms and improve cardiovascular health. Regular follow-up visits with a healthcare provider are essential to monitor the disease’s progression and adjust treatment as needed. Preventing recurrence through continued antibiotic prophylaxis is key to managing the condition effectively. The treatment plan should be tailored to the individual’s specific condition and managed by a healthcare professional experienced in treating rheumatic heart disease.