What Is Rheumatic Heart Disease (RHD)?
Rheumatic Heart Disease (RHD) is a long-term heart condition that develops after rheumatic fever, an inflammatory illness caused by an untreated or poorly treated strep throat infection (Group A Streptococcus). RHD can seriously damage the heart valves, leading to complications such as **heart failure, irregular heartbeats (atrial fibrillation), and even stroke.
The good news? RHD is both preventable and manageable with early diagnosis, proper treatment, and healthy lifestyle changes.
Understanding Rheumatic Fever
Rheumatic fever is an autoimmune response that occurs after a strep throat infection is left untreated. The body’s immune system, while fighting the bacteria, mistakenly attacks its own tissues—especially the heart, joints, skin, and brain.
It mostly affects children between 5 and 15 years old, but its complications can extend into adulthood, sometimes causing lifelong heart issues.
How Rheumatic Fever Leads to RHD
When rheumatic fever strikes repeatedly, it causes ongoing inflammation and damage to the heart valves. Over time, this leads to scarring, thickening, or narrowing of the valves , which interferes with proper blood flow and puts extra strain on the heart—ultimately raising the risk of serious cardiovascular conditions.
Common Symptoms of Rheumatic Fever
- High fever and painful, swollen joints (like arthritis)
- Tiredness and difficulty breathing
- Red skin rashes or small lumps under the skin
- Jerky, uncontrolled movements (known as Sydenham’s chorea )
- Chest pain or heart palpitations
Symptoms of Rheumatic Heart Disease (RHD)
Individuals living with chronic RHD may gradually develop symptoms such as:
- Shortness of breath, especially during physical activity
- Swelling in the feet, ankles, or abdomen due to fluid retention
- Irregular or rapid heartbeats (atrial fibrillation)
- Fatigue and constant tiredness
- Dizziness or fainting episodes
Causes and Risk Factor
Primary Causes
- Untreated strep throat or scarlet fever
- Repeated episodes of rheumatic fever
- Limited access to timely medical care, especially in under-resourced areas
Risk Factors
- Living in overcrowded or unhygienic environments
- Poor hygiene and lack of health awareness
- Family history of rheumatic fever or RHD
- Malnutrition and a weakened immune system
Prevention of Rheumatic Heart Disease
Primary Prevention: Stopping it at the Source
- Timely diagnosis and antibiotic treatment (like penicillin) for strep throat
- Promoting good hygiene to prevent infection spread
Secondary Prevention: Preventing Rheumatic Fever Recurrence
- Long-term antibiotic prophylaxis (monthly injections or daily tablets)
- Regular heart check-ups
- Avoiding exposure to individuals with untreated throat infections
Tertiary Prevention: Managing Established RHD
- Lifelong medications (like diuretics or anticoagulants)
- Surgery for valve repair or replacement in advanced cases
- Lifestyle changes to reduce the risk of heart failure
Treatment of Rheumatic Heart Disease
Medical Management
- Antibiotics to prevent further episodes of rheumatic fever
- Anti-inflammatory drugs (aspirin or corticosteroids) to control inflammation
- Heart failure medications like diuretics and beta-blockers
Surgical & Interventional Options
In more severe cases, the following procedures may be required:
- Balloon valvuloplasty: A non-surgical technique to open narrowed heart valves
- Valve repair or replacement: For significantly damaged valves
- Pacemaker implantation: In cases of serious arrhythmias
Living with Rheumatic Heart Disease
Diet & Nutrition
- Follow a low-sodium diet to manage fluid retention
- Eat a heart-healthy diet: fruits, vegetables, whole grains, and lean proteins
- Avoid processed foods and unhealthy fats
Exercise & Activity
- Engage in moderate physical activity (if approved by your doctor)
- Avoid intense exertion if you have symptoms of heart failure
- Attend routine heart evaluations
Mental Health & Well-being
- Practice stress management (yoga, deep breathing, meditation)
- Seek emotional support through counseling or support groups
Conclusion
Rheumatic Heart Disease is a preventable and manageable condition when addressed early. With timely treatment of strep throat, ongoing medical care, and healthy lifestyle changes, the risk of severe complications can be greatly reduced.
At Oxford Hospital, we focus on awareness, early prevention, and advanced treatment options to help our patients live healthier, fuller lives.
