Rheumatic Heart Disease (RHD) is a serious cardiovascular condition that results from rheumatic fever, an inflammatory disease that can affect many of the body’s connective tissues, especially those of the heart, joints, skin, and brain. RHD specifically refers to permanent damage to the heart valves caused by episodes of rheumatic fever, which itself is triggered by an infection with group A streptococcal bacteria.

Relationship Between Rheumatic Fever and Rheumatic Heart Disease:

  • Initial Infection: Rheumatic fever typically develops after an infection of the throat with group A streptococcus, which is also known for causing “strep throat.” The body’s immune response to this infection can become abnormal, leading to rheumatic fever if the initial infection is not properly treated.
  • Inflammatory Response: Rheumatic fever is characterized by a widespread inflammatory response that can affect many parts of the body. The heart is particularly vulnerable; the disease can cause inflammation in all layers of the heart—the endocardium, myocardium, and pericardium—a condition collectively referred to as pancarditis.
  • Heart Valve Damage: The most significant impact of rheumatic fever on the heart is its potential to cause chronic damage to the heart valves, particularly the mitral and aortic valves. The inflammation can lead to scarring of the valve leaflets, resulting in stenosis (narrowing of the valve) or regurgitation (leakage of the valve).
  • Progression to Chronic RHD: While the acute inflammation of rheumatic fever may subside, repeated episodes or severe initial attacks can lead to progressive valve damage, manifesting as RHD. This condition leads to chronic heart disease, which can be disabling and can significantly shorten life expectancy if not managed properly.

Long-term Consequences:

  • Chronic Heart Conditions: Individuals with RHD may develop complications such as atrial fibrillation, heart failure, and stroke due to the impaired function of the damaged heart valves.
  • Prevention of Recurrence: Patients with a history of rheumatic fever are often recommended to continue prophylactic antibiotics for years, sometimes for life, to prevent recurrence of rheumatic fever, which can exacerbate valve damage.

Understanding the connection between rheumatic fever and Rheumatic Heart Disease underscores the importance of prompt and effective treatment of strep throat and other streptococcal infections to prevent the development of rheumatic fever, and consequently, RHD. Regular medical follow-up and adherence to preventive antibiotic therapy are crucial for those at risk.

Last Update: June 3, 2024