Rheumatic Heart Disease 

Definition

Rheumatic heart disease (RHD) occurs when the heart valves are damaged as a result of acute rheumatic fever. If you suffer from RHD, blood cannot flow to your heart properly as your heart valves have trouble opening and closing.

 Rheumatic heart disease is very prevalent in remote Aboriginal and Torres Strait Islander communities where acute rheumatic fever is common.

Symptoms

You may not always have symptoms if you have rheumatic heart disease. However some warning signs include:

• Breathlessness in activity
• Chest pain
• Fainting
• Fever related to infection of damaged heart valves
• Heart palpitations
• Stroke
• Swelling
• Trouble breathing when lying down
• Waking from sleep and needing to sit or stand up

Causes

Rheumatic heart disease is caused by acute rheumatic fever or recurring rheumatic fever which has been left untreated.

Acute rheumatic fever is an inflammatory disease that develops if strep throat or scarlet fever – an infection with Group A streptococcus bacteria – is left untreated without antibiotics. Acute rheumatic fever is prevalent in developing nations or disadvantaged communities and most common among 5-15 year olds.

If you are susceptible you may experience an immune response if your strep throat is not addressed. This response can then target the brain, skin, joints and heart and may cause inflammation.

Diagnosis 

To diagnose rheumatic heart disease, your doctor may conduct one of the following tests: 

• Physical examination
• Medical history to check for past       acute rheumatic fever or strep infection
• Chest X-ray
• Electrocardiogram (ECG) Echocardiogram

Treatment

The type of treatment will depend on the severity of the rheumatic heart disease. Some options include:

• Medication to treat infection
• Balloons inserted through a vein to open up a valve
• Blood-thinning medicine to prevent stroke or to prepare for a heart valve replacement
• Heart valve surgery to repair or replace damaged heart valves
• Heart transplant 

Prevention

Rheumatic heart disease and acute rheumatic fever are both entirely preventable.

Antibiotic treatments including penicillin to treat strep throat can dramatically reduce the risk of acute rheumatic fever and consequently rheumatic heart disease.

If you have acute rheumatic fever, prompt diagnosis from your doctor is essential, combined with the appropriate medication, in order to prevent it from worsening and deteriorating into heart disease.

In some cases, you may need to continue taking preventative antibiotics such as prophylactic antibiotics for many years after acute rheumatic fever. This will be decided by your doctor who will consider the severity of your situation.