Rheumatic Heart Disease (RHD) is caused by damage to the heart valves and heart muscle from the inflammation and scarring due to rheumatic fever. Streptococcal bacteria cause rheumatic fever, which usually begins as a sore throat or tonsillitis in children.
Who are at risk?
Rheumatic fever mostly affects children in developing countries, especially where poverty is widespread.
• Chest pain
• Breathlessness on exertion
• Breathing problems when lying down
• Waking from sleep with the need .to sit or stand – Paroxysmal Nocturnal Dyspnoea
• Fever associated with infection of damaged heart valves
• Swelling – Oedema
• Fainting – Syncope
What happens to the heart in RHD?
The heart is a double pump with four chambers. Each chamber is sealed with a valve. The valves open and close in one direction only, preventing the blood from flowing backwards. RHD often involves damage to the heart valves. Typically, the damaged heart valve cannot open or shut properly. This interferes with the proper flow of blood through the heart. Without treatment, the damaged valve may continue to deteriorate.
• Heart failure. Heart is unable to pump blood effectively. The strain causes the heart to enlarge.
• Infection of damaged heart valves – infective endocarditis
• Stroke due to clots forming in the enlarged heart or on damaged valves. These clots then break off (embolise) and cause blockage in blood vessels in the brain.
• Regular check-ups with a cardiologist
• up-to-date flu (influenza and pneumococcal) vaccinations
• Regular (preventative) antibiotic to prevent Group A Streptococcus throat infections
Antibiotic treatment for sore throats
Good dental hygiene (tooth brushing. dental check-ups) as oral bacteria entering the bloodstream can increase the risk of complications including inflammation of the hearts inner lining
Antibiotics – may be given to some people before dental or surgical procedures to prevent bacterial infection of the damaged areas of the heart
Good prenatal care as pregnancy can make RHD worse