The treatment of Rheumatic Heart Disease (RHD) involves managing the symptoms, preventing progression of the disease, and addressing complications, especially those related to valve damage. The treatment strategies vary depending on the severity of the condition and can range from medical management to surgical interventions. Here’s a detailed look at the available treatment options for RHD:

1. Medical Management

  • Antibiotics: For patients with a history of rheumatic fever, long-term antibiotic prophylaxis is recommended to prevent recurrent attacks, which can worsen valve damage. Penicillin is commonly used, either orally or as a long-acting injection.
  • Anti-inflammatory Treatment: During active rheumatic fever, anti-inflammatory medications such as aspirin or corticosteroids are used to reduce inflammation, alleviate pain, and decrease fever.
  • Anticoagulants: For patients who have developed atrial fibrillation or those who have had valve replacement surgery, anticoagulants are prescribed to prevent blood clots. This is crucial to reduce the risk of stroke.

2. Surgical Interventions

  • Valve Repair or Replacement: In cases where valve damage leads to significant dysfunction (like severe stenosis or regurgitation), surgery may be necessary to repair or replace the affected valve(s). Valve repair is preferred to maintain the patient’s own tissue, but replacement with mechanical or bioprosthetic valves may be necessary if the damage is extensive.
  • Balloon Valvuloplasty: For certain types of valve stenosis, especially mitral stenosis, balloon valvuloplasty can be performed. This procedure involves inserting a balloon-tipped catheter into the valve and inflating it to widen the valve opening.

3. Management of Complications

  • Heart Failure Treatment: For patients experiencing heart failure symptoms due to RHD, medications such as diuretics (to reduce fluid accumulation), ACE inhibitors, or beta-blockers may be prescribed to help the heart function more efficiently and alleviate symptoms.
  • Arrhythmia Management: For arrhythmias like atrial fibrillation, medications to control heart rate and rhythm may be necessary.

4. Lifestyle Modifications

  • Regular Physical Activity: Encouraged within individual tolerance levels to maintain cardiovascular health.
  • Healthy Diet: A balanced diet low in salt and saturated fats can help manage risk factors for cardiovascular disease.
  • Regular Monitoring: Frequent check-ups are important to monitor the progression of valve disease, manage symptoms, and adjust treatments as needed.

5. Patient Education

  • Understanding the Disease: Educating patients and families about the nature of the disease, its progression, complications, and the importance of adherence to prescribed treatments and follow-up appointments.

6. Community and Supportive Care

  • Support Groups: Connecting with others living with RHD can provide emotional support and practical advice for managing the disease.

The management of RHD is complex and often requires a multidisciplinary approach, involving cardiologists, primary care physicians, and sometimes, cardiac surgeons. The focus is not only on treating the current symptoms and preventing progression but also on improving overall quality of life for the patient. Regular follow-ups and echocardiograms are critical to monitoring the condition and ensuring timely interventions when necessary.

Last Update: June 3, 2024