Rheumatic Heart Disease - An Overview

Introduction

Rheumatic heart disease or rheumatic heart disorder is a condition of the heart that is caused when the valves of the heart get damaged. This damage may be due to several underlying reasons. The prompt diagnosis, as well as treatment of rheumatic heart disease, is crucial in order to sustain and recover the standard functioning of the heart as well as the cardiovascular system as a whole. Rheumatic fever is one of the main reasons that lead to rheumatic heart disease. But not all cases or episodes of rheumatic fever may end in rheumatic heart disease. Those rheumatic infections that are left untreated generally persist in the patient and flow into the bloodstream, lodging the infective organism in the heart and blood vessels. Over time, the toxins released by these infective agents hamper the regular functioning of the heart by causing a significant level of damage to the heart valves.

What Are the Causes of Rheumatic Heart Disease?

Throat infections that are caused due to Streptococcal A, result in rheumatic fever. Rheumatic fever can be defined as an inflammatory response of the throat that is autoimmune in nature. This infection is referred to as strep throat or throat pharyngitis. Rheumatic fever is mostly seen in the younger age group, especially during childhood. If left untreated, this infection may cause life-long disability and hamper several vital organs, such as the heart. Mentioned below are some of the causes of rheumatic heart disease.

• Sore throat due to Streptococcus pyogenes.

• Upper respiratory tract infection.

• Scarlet fever.

• Continuous unhygienic practices.

• Family history of rheumatic heart disease.

• Low socioeconomic status.

• Acute rheumatic fever.

• Malfunctioning of the immune system.

• Recurrent scarring of the cardiac valves.

• Pregnant women suffering from rheumatic heart disease.

What Are the Signs and Symptoms of Rheumatic Heart Disease?

There are several symptoms, such as those mentioned below, of rheumatic heart disease that a patient suffering from rheumatic fever may clinically manifest.

• High-grade fever.

• Painful joints such as the knees, wrists, ankles, and elbows.

• Pain that moves between different parts of a bone.

• Fatigue.

• Chorea or uncontrolled jerks of the muscles.

• Rashes with pink rings.

• Rashes with clear centers.

• Nodules under the skin that are painless.

• Palpable nodule below the joints.

• Chest discomfort.

• Angina pectoris.

• Swelling of the abdomen.

• Abnormal murmurs or heart sounds.

• Shortness of breath.

• Swelling of the hands and feet.

• Rapid and irregular heartbeats.

• Palpitations.

• Arrhythmia.

• Heart failure.

• Increased volume of blood.

• High blood pressure.

• Commissural fusion.

Who Are at a Risk of Developing Rheumatic Heart Disease?

Rheumatic heart disease may be seen over all age groups, but mentioned below are the individuals that are highly prone to developing rheumatic heart disease in comparison to the general public.

• Children.

• Adolescents and children in underdeveloped nations.

• Youngsters with limited access to healthcare.

• Young and old who do not have the means to practice proper sanitation measures.

• People living in overcrowded and low-income locations.

• Pregnant women living in places where rheumatic heart disease has been announced as endemic.

• Patients suffering from high blood pressure.

• Indigenous populations.

What Are the Tests to Diagnose Rheumatic Heart Disease?

Rheumatic heart disease needs to be diagnosed at a very early stage in order to live a life free of complications. Mentioned below are several diagnostic measures for determining the presence of rheumatic heart disease. Before suggesting any diagnostic tools, the healthcare provider will evaluate the patient thoroughly for clinical manifestations. A physical exam, as well as detailed medical and drug history, is recorded. Family history is also questioned.

• Complete blood profile.

• Evaluating the increased immune response.

• Echocardiogram or a heart ultrasound in order to find a narrowed or leaking heart valve.

• Electrocardiogram to assess the electrical conduction of the heart.

• Auscultation.

What Is the Treatment for Rheumatic Heart Disease?

As of today, there is no established cure for a person suffering from rheumatic heart disorder. Thus the damage to the valves of the heart is permanent. Mentioned below are some of the options that can help patients with severe states of rheumatic heart disease.

• Surgical correction of valves of the heart.

• Repair of heart valves.

• Medication to correct the clinical manifestations of rheumatic heart disorder.

• Blood thinners.

• Antibiotic therapy for a rheumatic fever- Benzathine Penicillin G intramuscular every four weeks as per the healthcare provider for several.

What Are the Complications of Rheumatic Heart Disease?

Rheumatic heart disease is a condition that is a result of untreated and long-standing rheumatic fever. If diagnosed at an early stage, rheumatic heart disease can be successfully prevented. But in the majority of the cases, early detection is next to impossible due to financial constraints and limited healthcare access to the infected individual. Mentioned below are a few complications of rheumatic heart disease.

• Arrhythmia or abnormal rhythms of the heart.

• Atrial fibrillation or abnormal heartbeat in the upper chambers of the heart is called the atrium.

• Heart failure since the heart does not work efficiently and fails to pump blood throughout the cardiovascular system and the body.

• Stroke.

• Blood clots.

What Is the Prognosis of Rheumatic Heart Disease?

The prognosis of rheumatic heart disease varies depending on the severity of the disease and the patient's overall health. People with mild RHD may not experience any symptoms and may have a normal life expectancy. However, people with moderate to severe RHD may experience symptoms such as shortness of breath, chest pain, and fatigue. These symptoms can interfere with daily activities and may lead to heart failure.

Conclusion

Rheumatic heart disease is a direct result of rheumatic fever that has not been diagnosed or treated; nevertheless, there several reasons that may cause this disease. Rheumatic heart disease is preventable. Once the disease is contracted, it cannot be treated. The disease is permanent and demands a long-term management strategy. The individual continues to live life with a positive outlook by management of the symptoms of rheumatic heart disease. The important strategy for keeping rheumatic heart disease at bay is the prompt treatment of throat infections by following antibiotic therapy. Patients suffering from rheumatic heart disease that is well-managed may live a high-quality life with the correct treatment, which can even delay or completely prevent an episode of heart failure.