Chronic Heart Condition Caused by Rheumatic Fever: Prevention and Control

Rheumatic heart disease (RHD) is a chronic heart condition that results from rheumatic fever, an inflammatory disease caused by an untreated or inadequately treated group A streptococcal infection. This condition can cause severe damage to heart valves, leading to long-term health complications, including heart failure, atrial fibrillation, and stroke. However, RHD is preventable and manageable with early intervention, proper treatment, and lifestyle adjustments.

What is Rheumatic Fever?

Rheumatic fever is an autoimmune reaction that occurs after an untreated throat infection caused by Streptococcus pyogenes (group A streptococcus). It primarily affects children between 5 and 15 years old, though its consequences can persist into adulthood. If left untreated, the disease leads to rheumatic heart disease, which can cause permanent damage to heart valves, requiring lifelong medical care and, in severe cases, surgical intervention.

How Rheumatic Fever Leads to Rheumatic Heart Disease

The immune system mistakenly attacks healthy tissues, causing inflammation in the heart, joints, skin, and brain. Over time, repeated episodes of rheumatic fever lead to scarring and narrowing of the heart valves, affecting normal blood flow and increasing the risk of heart failure and other cardiovascular complications.

Key Symptoms of Rheumatic Fever

• Fever and joint pain (arthritis-like symptoms)
• Fatigue and shortness of breath
• Skin rash or nodules
• Uncontrolled body movements (Sydenham’s chorea)
• Chest pain and palpitations

Symptoms of Rheumatic Heart Disease

Patients with chronic rheumatic heart disease may experience the following symptoms over time:

• Shortness of breath, especially with exertion
• Swelling of the feet, ankles, or abdomen (due to fluid retention)
• Irregular or rapid heartbeats (atrial fibrillation)
• Fatigue and weakness
• Dizziness or fainting episodes

Causes and Risk Factors

Primary Causes

• Untreated streptococcal infections (strep throat or scarlet fever)
• Repeated episodes of rheumatic fever
• Lack of access to medical care in underserved regions

Risk Factors

• Living in crowded or unsanitary conditions
• Poor hygiene and limited healthcare access
• Genetic predisposition (family history of rheumatic fever or RHD)
• Malnutrition and weakened immune system

Prevention of Rheumatic Heart Disease

Primary Prevention: Treating Strep Throat Early

• Prompt diagnosis and treatment of strep throat with antibiotics (penicillin or amoxicillin).
• Raising awareness about hygiene practices to prevent bacterial infections.

Secondary Prevention: Preventing Recurrence of Rheumatic Fever

• Long-term antibiotic prophylaxis (monthly penicillin injections or daily oral antibiotics).
• Regular medical follow-ups to monitor heart health.
• Avoiding exposure to individuals with untreated strep throat.

Tertiary Prevention: Managing Established RHD

• Lifelong medical management with anticoagulants and diuretics.
• Surgical interventions like valve repair or replacement in severe cases.
• Lifestyle modifications to reduce the risk of heart failure.

Treatment of Rheumatic Heart Disease

Medical Management

• Antibiotic therapy to prevent recurrence of rheumatic fever.
• Anti-inflammatory medications (aspirin, corticosteroids) to manage inflammation.
• Diuretics and beta-blockers to control heart failure symptoms.

Surgical and Interventional Treatments

Certain heart conditions require advanced surgical or interventional procedures to restore proper heart function and improve a patient’s quality of life. These treatments include:

• Balloon valvuloplasty: A minimally invasive procedure to open narrowed valves.
• Valve repair or replacement: For severely damaged heart valves.
• Pacemaker implantation: If severe arrhythmias develop.

Living with Rheumatic Heart Disease

Diet and Nutrition

• Low-sodium diet to reduce fluid retention.
• Heart-healthy foods like fruits, vegetables, whole grains, and lean proteins.
• Limiting processed foods and trans fats.

Exercise and Physical Activity

• Moderate exercise to maintain cardiovascular health.
• Avoiding strenuous activities if experiencing heart failure symptoms.
• Regular check-ups to assess heart function.

Mental Health and Well-being

• Stress management techniques like meditation and breathing exercises.
• Support groups and counseling for emotional well-being.

Conclusion

Rheumatic heart disease is a serious yet preventable and manageable condition. Early detection and treatment of strep throat, along with long-term medical care and lifestyle adjustments, can significantly reduce its impact. At EMC Hospital, we emphasize awareness, prevention, and state-of-the-art treatments to ensure better outcomes for individuals affected by this condition.