Rheumatic Heart Disease: A Preventable Threat to Young Hearts
RHEUMATIC HEART DISEASE (RHD)
1. Causes:
Rheumatic Heart Disease is a chronic condition resulting from rheumatic fever, which is a complication of untreated or poorly treated streptococcal throat infection (Strep throat) caused by Group A Streptococcus bacteria.
- Initial trigger: Strep throat or scarlet fever.
- Immune response: The body’s immune system attacks the heart tissues (especially the valves) while trying to fight the strep infection.
- Progression: Repeated rheumatic fever episodes can cause scarring and deformities in the heart valves, especially the mitral and aortic valves.
2. Symptoms:
Symptoms of RHD may vary depending on the severity and the affected heart valves.
Early symptoms (related to rheumatic fever):
- Fever
- Joint pain and swelling (migratory arthritis)
- Fatigue
- Nosebleeds
- Chest pain
- Skin rashes or nodules
- Rapid or irregular heartbeat
Chronic RHD symptoms:
- Shortness of breath (especially on exertion or when lying down)
- Fatigue and weakness
- Swelling of the legs, ankles, or abdomen
- Palpitations
- Chest discomfort
- Fainting spells (in severe cases)
- Heart murmur (detectable by a doctor using a stethoscope)
3. Prevention:
Primary Prevention:
- Early diagnosis and treatment of strep throat with antibiotics (usually penicillin) to prevent rheumatic fever.
- Public health measures: Improving hygiene, access to medical care, and awareness in affected communities.
Secondary Prevention:
- Long-term antibiotics (e.g., monthly penicillin injections) to prevent recurrence of rheumatic fever in those who have had it before.
- Regular medical follow-up for people with a history of rheumatic fever.
4. Treatment:
Medical Management:
- Antibiotics to treat or prevent streptococcal infections.
- Anti-inflammatory drugs (like aspirin or corticosteroids) to reduce inflammation during acute rheumatic fever.
- Medications for heart failure (e.g., diuretics, beta-blockers, ACE inhibitors) if RHD leads to heart dysfunction.
- Anticoagulants if there is a risk of blood clots due to irregular heart rhythm or damaged valves.
Surgical Management:
- Valve repair or replacement surgery may be necessary in severe cases to restore normal heart function.
Key Takeaways:
- RHD is a preventable disease that stems from inadequate treatment of streptococcal infections.
- It remains a major cause of morbidity and mortality in low- and middle-income countries, especially in children and young adults.
- Prevention and early treatment of strep throat are the most effective ways to eliminate RHD.