A chronic heart condition caused by rheumatic fever that can be prevented and controlled

Rheumatic heart disease or rheumatic fever is an inflammatory disease results due to neglect of strep throat or scarlet fever. Strep throat or scarlet fever are caused by streptococcus, a bacteria. Usually seen in children of 5 – 15 years, rheumatic heart disease has its terrible impact on adult’s health. The fall-out of rheumatic heart disease is disastrous, evident as damaged heart valves and heart failure.

CAUSES

Streptococcus pyogenes causes throat infection, and leads to rheumatic fever. Group A rheumatic infections may cause infections of the skin and other parts of the body, however rarely cause rheumatic fever. A protein in strep bacterium is similar to certain tissues of the body, which helps to confuse the immune system. The body’s immune system considers strep bacterium as body tissue causing inflammation.

SYMPTOMS

Rheumatic fever or rheumatic heart disease occurs after two to four weeks after a strep throat infection. The signs and symptoms of rheumatic heart disease includes, Fever, Painful and tender joints -most often the ankles, knees, elbows or wrists; less often the shoulders, hips, hands and feet, Pain in one joint that migrates to another joint, Red, hot or swollen joints, Small, painless nodules beneath the skin, Chest pain, Heart murmur, and Fatigue.

Other symptoms of rheumatic heart disease includes flat or slightly raised, painless rash, Jerky, uncontrollable body movements (Sydenham chorea or St. Vitus’ dance) ‰ÛÓ most often in the hands, feet and face, and Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea.

RISK FACTORS AND COMPLICATIONS

Some may carry genes that lead to developing of rheumatic fever. Overcrowding, poor sanitation and other unhygienic conditions help in rapid transmission and multiple exposure to strep bacteria. Rheumatic heart disease may permanently damage the heart. Rheumatic fever causes inflammation and produces long-term complications. The complications of rheumatic heart disease are seen as, valve stenosis, valve regurgitation and damage to heart muscle.

Valve stenosis is a condition where the heart valve narrows, leading to decreased blood flow. Valve regurgitation is marked by valve leaking that allows blood flow in the wrong direction. Damage to heart muscle leads to poor pumping function of the heart. Rheumatic heart disease may also present irregular heart beat (atrial fibrillation) and sudden heart failure.

TESTS AND DIAGNOSIS

On visit to the doctor, the patient is examined for inflammation of the joints, fever, skin rashes, heart rhythm and inflammation of the nervous system. Blood test helps to detect antibodies to strep bacteria, circulating in the blood. ECG or electrocardiogram helps to record the electrical signals of the heart. ECG report helps the doctor to identify the healthy or poor functioning, healthy or poor of the heart. Echocardiogram is also advised to record live-action images of the heart.

TREATMENTS AND DRUGS

The doctor prescribes medications/drugs as per the stage of the rheumatic heart disease. Medications are usually administered to relieve symptoms, control inflammation and prevent recurring episodes of rheumatic fever. The disease may subside temporarily, but may recur after many years following treatment. Continuous follow-up with the doctor and appropriate check-ups periodically will be of great help to check rheumatic heart diseases.