Rheumatic Heart Disease (RHD) primarily affects the heart valves and can lead to a variety of symptoms that generally depend on the severity and specific valves involved. The symptoms may not appear until years after episodes of rheumatic fever, and they tend to worsen over time as the valve damage progresses. Here are the key symptoms associated with RHD:

1. Heart Murmurs

  • Explanation: This is often the first detectable sign of RHD. A heart murmur is an unusual sound heard between heartbeats, which is typically detected by a healthcare provider using a stethoscope. The murmur results from turbulent blood flow due to valve damage.

2. Shortness of Breath (Dyspnea)

  • Details: This symptom can occur initially during exercise or physical activity but may progress to occurring even at rest as the disease worsens. It is due to reduced cardiac output or from pulmonary congestion resulting from fluid buildup caused by the heart’s inability to pump efficiently.

3. Chest Pain or Discomfort

  • Typically: The pain is not as pronounced as that seen in coronary artery disease but can occur due to increased stress on the heart or decreased blood flow to the heart muscle itself.

4. Fatigue

  • Explanation: As the heart struggles to meet the metabolic demands of the body, patients may feel unusually tired or fatigued, particularly after physical exertion.

5. Palpitations

  • Cause: Patients may experience sensations of an irregular heartbeat, fluttering, or pounding due to arrhythmias, which are common as the structure of the heart changes and atrial fibrillation develops.

6. Swelling of Ankles and Feet (Edema)

  • Mechanism: Swelling occurs due to fluid retention, which is often a sign of worsening heart function or right-sided heart failure when the heart cannot pump blood effectively through the body.

7. Weight Gain

  • Related to: Accumulation of fluid (edema) can also lead to sudden weight gain, which is a sign of congestive heart failure.

8. Syncope or Dizziness

  • Occurrence: Less common, but can occur if the brain’s blood supply is momentarily decreased, which can happen due to the heart’s reduced pumping ability or arrhythmias.

9. Cough

  • Associated With: Patients may develop a persistent cough, which can be worse when lying down. It’s often related to fluid build-up in the lungs.

10. Hemoptysis

  • Condition: Coughing up blood, although rare, can occur in severe cases due to extreme pulmonary pressure leading to rupture of small capillaries in the lungs.

The progression and severity of these symptoms typically prompt further evaluation and confirmation of RHD through diagnostic imaging such as an echocardiogram. Early detection and treatment are critical to managing symptoms and slowing the progression of the disease.

Last Update: June 3, 2024